HEALTHY  BABIES 

S.JOSEPHINE  BAKER 


Columbia  SBinitietsiitp 
intJ)eCit|)ofi^eUjpotfe 

College  of  ^})j)gicians;  anb  burgeons; 


^^eferente  Hihtavp 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/healthybabiesvolOObake 


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HEALTHY    BABIES 

A  Volume 

Devoted  to  the  Health  of  the 
Expectant  Mother  and  the 
care  and  welfare  of  the  child 

BY 

S.    JOSEPHINE    BAKER,   M.  D.,  D.  P.  H. 

Director,  Bureau  of  Child  Hygiene,  Depart- 
ment of  Health,  New  York  City. 

Consultant  in  Child  Hygiene,  United  States 
Public  Health  Service. 

Former  President  American  Child  Hygiene 
Association. 

Lecturer  on  Child  Hygiene  at  Teachers  Col- 
lege, Columbia  University,  New  York 
University  and  Bellevue  Hospital  Medi- 
cal College. 

Member  American  Medical  Association. 

Fellow  New  York  Academy  of  Medicine. 


THE   FEDERAL    PUBLISHING    COMPANY 

MINNEAPOLIS.  MINNESOTA 
1920 


Z^l—  I  5  7-2- "2- 


Copyright  1920 

by  the 

Federal  Publishing  Co. 

Minneapolis 

Minn, 


II 


TO 

MY  FATHER 

AND 

MY  MOTHER 

THIS  BOOK  ON   CARE  OF 

MOTHER   AND    CHILD 

IS   LOVINGLY   AND 

GRATEFULLY 

DEDICATED 


III 


PREFACE 

The  methods  and  advice  given  in  this  book 
on  care  of  babies  are,  first  of  all,  intended  to 
be  used  in  keeping  babies  well.  The  book  is  in 
no  sense  intended  as  a  method  of  treating  sick 
babies,  nor  should  the  advice  that  is  given  ever 
take  the  place  of  the  individual  care  that  can 
be  offered  by  a  doctor.  The  methods  of  keep- 
ing babies  well  are  simple  and  easy,  but  the 
methods  of  curing  babies  after  they  are  sick 
are  difficult  and  often  complicated.  It  has 
been  proved  over  and  over  again  that  babies 
can  be  kept  well  with  very  little  effort,  and 
that  any  intelligent  mother  can  learn  all  that 
is  needful  to  assure  good  health  in  her  baby.  J 
There  are  certain  minor  forms  of  illness  which 
can  be  corrected  or  cured  simply  by  readjust- 
ment of  the  hygiene  of  the  baby's  life  or 
perhaps  by  the  use  of  some  simple  household 
remedies,  and  there  is  no  reason  why  the 
mother  should  not  know  and  apply  the  proper 
treatment  in  cases  of  this  kind,  but  if  actual 
illness  occurs  there  should  be  no  delay  in 
obtaining  the  help  of  a  qualified  physician. 

Saving  babies  has  proved  to  be  one  of  the 
most  interesting  and  satisfactory  types  of 
health  work  that  has  ever  been  carried  out  in 
this,  or  any  other  country.  In  every  city  or 
rural  community  where  there  has  been  any 


PRE  FA  CE 

systematic  effort  to  reduce  the  baby  death 
rate,  the  results  have  been  prompt  and  satis- 
factory. During  the  past  ten  years  in  many  of 
the  large  cities  of  this  country  the  baby  death 
rate  has  been  cut  in  half.  The  saving  of  infant 
life  during  this  period  has  been  beyond  all  ex- 
pectation of  what  it  had  been  thought  could 
be  accomplished  by  proper  community  action, 
and  intelligent  mother  care.  After  all,  these 
are  the  only  two  things  that  are  necessary: 
first,  the  community  must  provide  the  neces- 
sary surroundings  and  equipment  for  the 
mother,  and  in  many  instances  it  must  give 
her  the  instruction  which  will  enable  her  to 
have  an  intelligent  idea  of  the  simple  methods 
of  baby  care;  second,  the  mother  must  use  the 
knowledge  which  she  has  gained,  and  must 
make  use  of  all  the  community  helps  and  aids 
in  seeing  that  her  baby  is  cared  for  in  a 
proper  manner.  The  community  can  furnish 
decent  housing,  clean  streets,  clean  water, 
pure  milk,  parks  and  playgrounds  and  oppor- 
tunities for  wholesome  living.  The  mother 
can  use  these  in  assuring  a  healthful  and  whole- 
some life  not  only  to  her  baby,  but  to  her  other 
children. 

One  of  the  most  interesting  facts  that  have 
been  ascertained  in  our  efforts  to  keep  babies 
well  is  that  the  simple  things  are  best.  During 
the  past  few  years  there  has  been  a  great 

VI 


PRE  FA  CE 

reaction  from  the  complicated  and  over-solicit- 
ous methods  of  baby  care  of  the  past.  There 
is  no  question  whatever  that  more  children 
have  been  killed  by  overcare  than  by  lack  of 
care.  There  is  a  happy  medium,  too,  between 
the  rigid  methods  of  ultra-scientific  baby  care, 
with  its  lack  of  human  contact,  and  its  stern, 
methodical  routine,  and  the  happy-go-lucky, 
careless,  neglectful  way  of  handling  infants, 
the  disastrous  results  of  which  have  been 
evident  in  the  past.  This  middle  way,  which 
is  the  sensible  and  successful  one  for  keeping 
babies  alive  and  well,  has  as  its  first  principle 
the  utmost  simplicity,  both  in  surroundings 
and  methods. 

A  great  deal  of  common  sense  is  needed  in 
handling  babies;  regularity  in  feeding,  atten- 
tion to  proper  methods  of  hygiene,  proper 
adherence  to  the  rules  regarding  the  right 
kind  of  clothing,  fresh  air,  exercise,  sleep  and 
quiet,  all  are  essential,  but  they  must  not  take 
the  form  of  rigid  routine,  to  be  carried  out  to 
the  exclusion  of  the  baby's  human  needs. 
After  all,  no  baby  will  live  unless  he  has  that 
intimate,  human  contact  which,  for  want  of  a 
better  name,  we  call  "mothering." 

Every  baby  must  be  taken  up  in  his  mother's 
arms  not  only  once,  but  several  times  a  day. 
There  is  a  time  and  a  place  for  this,  however, 
and  over-handling  and  over-fussiness  are  just 

VII 


PRE  FA  CE 


as  harmful  as  lack  of  any  care.  It  is  of  the 
utmost  importance,  therefore,  that  in 
studying  this  book,  and  in  applying  its 
principles,  the  mother  must  never  lose  sight 
of  the  fact  that  the  intimate  relationship  be- 
tween herself  and  her  baby  may  be  main- 
tained, yet  every  detail  of  proper  baby  care 
may  be  carried  out  at  the  same  time.  It  has 
been  found  over  and  over  again  that  babies 
who  are  perfectly  well  may  be  placed  in 
properly  equipped  institutions  where  they  are 
given  all  that  modern  science  can  devise  in 
the  way  of  the  most  approved  methods  of 
baby  care,  yet  such  babies  will  sicken  and  die 
if  they  are  not  taken  up  at  frequent  inter- 
vals and  held,  cared  for,  and  really  loved  by 
some  woman  who  has  the  mother  instinct. 

It  may  readily  be  assumed  that  there  is  no 
need  whatever  for  calling  the  mother's  atten- 
tion to  this  essential  relationship  between  her- 
self and  her  baby,  and  asking  her  not  to 
neglect  it.  The  only  reason  why  this  question 
has  been  referred  to  at  all  is  because  in  the 
over-anxiety  to  give  the  babies  the  best  of 
care,  there  has  been  a  tendency  to  accentuate 
the  more  material  things  in  the  baby's  life,  and 
to  neglect  this  human  element  which  is  of  the 
utmost  importance.  A  wise  and  intelligent 
mother  is  probably  the  highest  representative 
of  humanity.     Her  intuition  and  inclination 

VIII 


PRE  FA  CE 


accentuate  her  mother  love.  Her  wisdom  and 
intelHgence  should  teach  her  how  to  direct 
that  love  into  the  wisest  and  sanest  channels. 

The  best  way  to  use  this  book  is  to 
read  it  through  so  that  the  general  subject 
matter  may  be  familiar.  It  is  well  to  study 
the  chapters  on  the  routine  care  of  the 
baby  so  that  bathing,  airing,  clothing,  ex- 
ercise, and  all  the  other  important  details  of 
the  baby's  life  may  be  arranged  in  advance, 
and  followed  without  interruption.  In  any 
book  on  health  matters  certain  directions  must 
of  necessity  be  repeated  many  times  with 
reference  to  different  incidents,  and  some- 
times the  same  type  of  care  will  be  discussed 
from  various  points  of  view.  In  order  to 
learn  all  that  the  book  contains  on  any  given 
subject,  the  contents  should  be  consulted. 
The  glossary  contains  the  technical  words  that 
have  been  used  in  the  book,  with  their  mean- 
ing. If  there  is  the  slightest  doubt  as  to  the 
exact  meaning  of  any  word,  it  should  be 
looked  up  in  the  glossary. 

There  have  also  been  inserted  in  this  book 
three  sets  of  baby  record  forms.  It  is  hoped 
that  these  may  be  not  only  of  immediate  value 
to  the  mother,  but  that  they  will  form  an 
important  permanent  record  of  the  various 
phases  of  the  baby's  life. 

S.  Josephine  Baker. 

IX 


CONTENTS 

Chapter  I.    The  Nursery 

Furniture  and  other  furnishings.  Ventilation.  Temperature. 
Lighting.  Toys.  Baby  carriages.  Record  book .. .  Pages  1-10 
Chapter  II.    Growth  and  Development 

Weight:  scales.  Height.  Relation  between  size  of  head  and 
chest.  Muscular  development:  time  that  head  and  body  should 
be  held  erect.  Development  of  sight,  hearing,  speech.  Teeth 
and  their  eruption.  Teething  and  its  disorders.  Early  care  of 
the  teeth.  Development  of  the  head.  Hair,  skin,  breasts. 
Lifting  the  baby.  Prevention  of  prominent  ears.  Training  of 
bowels  and  bladder.  Suppositories.  Rectal  injections.  Bowel 
irrigations.  Bad  habits:  pacifiers,  thumb-sucking,  nail-biting, 
masturbation Pages  11-Ifi 

Chapter  III.     Clothing 

List  of  clothing  needed  for  the  baby.  How  the  clothes  should 
be  made.  Difference  between  summer  and  winter  clothing. 
Method  of  dressing  the  baby Pages  4i-50 

Chapter  IV.  Bathing 
Equipment.  Temperature  of  room.  Temperature  of  water. 
Time  of  bath.  Method  of  giving  bath.  Sponge  bath.  Tub  bath. 
Care  of  the  genital  organs.  Circumcision.  Care  of  the  diapers. 
Care  of  the  eyes,  nose,  mouth,  ears,  navel.  Warm  and  cool 
baths.  Alcohol  baths,  bran  baths,  soda  baths,  mustard  baths, 
salt  baths Pages  61-62 

Chapter  V.  Fresh  Air,  Sleep  and  Quiet,  Exercise 
Value  of  fresh  air.  Airing  of  room.  Temperature  of  sleeping 
room.  Method  of  indoor  airing.  Outdoor  airing.  Sleeping 
outdoors.  Sleep  and  quiet.  How  to  put  the  baby  to  sleep. 
Amount  of  sleep.  Sleeplessness:  treatment.  Prevention  of 
nervousness.  Exercise:  methods;  necessity  for  crying.  Various 
types  of  cries;  how  to  recognize  them;  how  to  deal  with 
them Pages  63-80 

Chapter  VI.  Feeding 
Breast  feeding:  when  undesirable.  Difficulty  in  nursing. 
Care  of  the  nipples  and  breasts.  Hygiene  of  the  nursing  mother. 
Nursing  habits.  Position  of  the  baby  while  feeding.  Signs  of 
over-feeding.  Milk  plentiful,  but  poor  in  quality.  Milk  scanty 
but  of  good  quality.     Weaning.     Substitute  feeding.     Composi- 

XI 


CONTENTS 


tion  of  human  and  cow's  milk.  Cow's  milk:  type  of  cows  to  be 
selected.  Production  of  milk.  Care  of  the  milk  after  produc- 
tion: in  the  home.  Types  of  milk  sold.  Refrigerators.  Use  of 
thermos  bottles.  Relative  value  of  raw  and  pasteurized  milk. 
Sterilized  milk:  how  prepared;  when  advised;  result  of  use. 
Pasteurized  milk:  how  prepared,  its  value  and  methods  of  use. 
Modification  of  milk:  principles.  Methods  of  choosing  proper 
formulae.  Complete  formulae  for  modifying  cow's  milk  for 
infant  feeding.  Amount  at  each  feeding.  Intervals  of  feeding. 
Utensils  needed  in  modifying  milk.  Method.  Care  of  the 
bottles.  Care  of  the  nipples.  Increasing  or  decreasing  the 
amount  of  food  or  strength  of  formula.  Use  of  other  in- 
gredients in  milk  modification.  Condensed  milk  and  proprietary 
foods.     Additional  feeding  under  one  year Pages  81-126 

Chapter  VII.    Stomach  and  Bowel  Disorders 
Cause,  prevention  and  treatment  of  loss  of  appetite,  regurgita- 
tion, vomiting.     Stools:  abnormal  stools;  diarrhoea:  its  preven- 
tion.    Constipation.     Colic  and  wind.     Malnutrition  and  maras- 
mus   Pages  127-14.1 

Chapter  VIII.  Minor  Illnesses  and  Ailments 
How  to  detect  symptoms  of  illness.  Method  of  taking  tem- 
perature, pulse,  respiration.  Convulsions  or  spasms.  Worms. 
Rickets.  Scurvy.  Sprue  or  thrush.  Prickly  heat.  Earache. 
Hiccoughs.  Skin  diseases:  eczema,  intertrigo.  Croup,  acute 
catarrhal  bronchitis Pages  14^-172 

Chapter  IX 
Food  recipes Pages  173-179 

Chapter  X 
Nursery  remedies Pages  180-184- 

TABLE  OF  MEASURES Page  185 

GLOSSARY Pages  186-194 

NOTES 
Baby's  record  of  weight,  height,  first  birthday,  development, 
feeding,  special  events Pages  195-209 


XII 


ILLUSTRATIONS 

Page 
Frontispiece 

Measuring  the  Baby 18 

Baby  Scales 19 

Chart  of  Teeth 23 

Method  of  Lifting  the  Baby 34 

Method  of  Holding  the  Baby 35 

Cardboard  Cuff  to  Prevent  Thumb-Sucking 38 

Baby  Clothes 50 

Bathing  the  Baby 50  to  51 

Bath  Thermometer  and  Clinical  Thermometer 66 

Hess  Home-Made  Refrigerator 67 

Utensils  for  Modifying  Milk 114 

Testing  Nipple  for  Right  Flow  of  Milk 115 

Method  of  Syringing  the  Ear 131 

Weight  Chart 206 


XIII 


HEALTHY  BABIES 

CHAPTER  I 

THE  NURSERY 

Two  laws  of  the  nursery  are  simplicity  and 
cleanliness.  The  room  in  which  the  baby  is 
to  live  should  not  resemble  a  hospital  ward 
with  its  unrelieved  bareness  and  whiteness, 
neither  should  it  be  the  opposite  extreme — an 
over-furnished  room  with  upholstered  furni- 
ture and  carpets.  The  right  type  of  room  is 
one  in  which  everything  may  be  washed,  but 
it  is  not  necessary  to  sacrifice  beauty  and 
harmony.  A  room  with  at  least  two  windows 
and  a  southern  exposure  is  best.  If  such  a 
room  is  not  available,  the  brightest,  airiest, 
and  quietest  room  in  the  house  should  be  given 
over  to  the  use  of  the  baby. 

Painted  walls  are  preferable.  If  paper  is 
to  be  used,  either  that  or  the  paint  may  be  a 
soft  gray-green  in  color,  or  a  light  buff  or  tan. 
The  floors  should  be  bare,  preferably  finished 
with  shellac  or  an  oil  dressing  which  keeps  the 
dust  from  rising.  If  the  floor  is  not  in  suitable 
condition  to  be  left  bare,  plain  linoleum  makes 
an  excellent  covering.  Rugs  should  be  small, 
easily  handled,  and  of  some  washable  material. 
Common  cotton  rugs  are  best.  If  only  one 
set  of  shades  is  to  be  used  on  the  windows,  dark 


HE  A L TH Y    BABIES 


ones  should  be  selected.  Plain  muslin  cur- 
tains may  be  fastened  directly  to  the  sash,  so 
that  when  the  window  is  opened,  the  curtains 
will  go  up  with  it. 

Furniture  and  Other  Furnishings 

While  the  baby  should  always  sleep  alone, 
during  the  early  months  of  life  it  may  be 
necessary  for  the  mother  or  nurse  to  sleep  in 
the  same  room.  The  furnishings  of  the 
nursery,  therefore,  may  include  a  single,  full 
length  bed,  in  addition  to  the  crib  or  bassinet. 

There  is  no  real  reason  why  the  baby  should 
not  sleep  in  a  crib  from  the  time  it  is  born,  but 
if  a  crib  is  not  available,  a  bassinet  may  be 
used  for  the  first  few  weeks.  Many  types  are 
sold,  but  there  is  nothing  better  than  an 
ordinary  clothes  basket  for  this  purpose.  A 
large  box  may  be  used  if  a  basket  is  ^  not 
available.  The  basket  or  box  should  be  lined 
with  thin  padding,  consisting  of  cotton  batting 
between  two  layers  of  cloth  or  silk.  ^  This 
lining  is  sewed  or  fastened  around  the  inside 
of  the  basket,  or  the  sides  of  the  crib  so  that 
no  direct  draft  will  fall  upon  the  baby.  A 
felt  or  hair  mattress  is  advised,  and  is  to  be 
placed  in  the  bottom  of  the  bassinet.  The  bed 
should  be  made  up  first  with  a  rubJDer  sheet 
spread  over  the  mattress,  next  a  thin  cotton 
mattress  pad  and  a  cotton  sheet.    A  covering 


THE     NURSERY 


sheet  and  two  light  weight  but  warm  blankets 
or  a  small  down  comfortable  are  advised. 
Pillows  are  not  necessary. 

In  addition  to  the  crib  or  bassinet,  the  following  nursery  fittings 
will  be  found  useful: 

Two  low  chairs,  without  arms.     One  may  be  a  rocking  chair. 

A  chiffonier  or  closet  for  the  baby's  clothes.  This  may  be 
built  into  the  room  or  may  be  removable. 

A  small  bureau  or  chest  of  drawers. 

A  low  table  about  36  x  24  inches,  and  not  over  two  feet  in 
height.  A  larger  table  may  be  used,  if  desired.  The  ordinary 
kitchen  table  cut  down  to  the  proper  height  answers  the  purpose 
well.  Half  the  table  should  be  used  for  toilet  articles,  and  the 
other  half  for  dressing  the  baby. 

Two  shelves  at  convenient  heights  over  the  table.  These 
should  be  open  so  that  the  articles  placed  on  them  may  be  easily 
reached,  and  so  that  they  may  be  cleaned  readily. 

A  small  rack  for  the  baby's  clothes.  The  best  type  is  the 
ordinary  low  clothes  horse. 

A  three-fold  screen.  This  should  preferably  be  made  of  plain 
wood  which  may  be  painted  white.  A  high  clothes  horse  will  do 
admirably  for  the  purpose.  The  panels  may  be  made  of  white 
muslin  so  that  they  may  be  washed,  and  they  may  be  gathered 
on  tapes  at  top  and  bottom,  and  fastened  to  the  individual  folds 
of  the  screen. 

A  tin  or  rubber  bathtub  which  may  be  placed  under  the  table 
when  not  in  use. 

A  pair  of  scales. 

Two  wash  basins. 

Two  pails  with  covers,  for  diapers. 

A  small  size  chamber,  made  especially  for  babies'  use.  A 
round  dish,  with  broad,  flat  edges,  may  be  substituted. 

A  wall  thermometer  which  should  be  hung  over  the  head  of 
the  baby's  crib. 

A  hot  water  bag,  with  flannel  cover. 


HE  A L TH Y    BABIES 


A  soft  blanket,  about  four  feet  square. 

A  rubber  sheet,  four  feet  square. 

Six  well  laundered,  fairly  old,  soft  towels. 

Four  wash  cloths.  Two  to  be  used  for  the  face  and  two  for  the 
body.  Those  for  the  face  may  be  woven,  and  those  for  the  body 
knitted,  or  there  may  be  different  colored  borders  for  the  two 
sets,  so  that  they  may  always  be  kept  for  the  same  use. 

A  soap  dish. 

A  soft  brush  for  the  hair. 

On  the  shelf  may  be  placed  the  few  drugs  and  other  small 
articles  which  may  be  needed  from  time  to  time.  These  will 
vary  according  to  the  doctor's  directions  for  the  individual  baby, 
but  the  following  will  be  found  valuable  in  practically  every 
household: 

Milk  of  magnesia  Bicarbonate  of  soda 

Castor  oil  Zinc  oxide  ointment 

Boric  acid  powder  Stearate  of  zinc  powder 

Tube  of  white  vaseline 

Toilet  Articles 

Roll  of  absorbent  cotton  Talcum  powder 

Castile  soap  Large  safety  pins,  two  dozen 

Bath  thermometer  Small  safety  pins,  two  dozen 
Medicine  glass 

Ventilation 

Fresh  air  for  the  baby  is  essential  in  every 
room,  both  day  and  night,  but  care  must  be 
taken  to  see  that  there  are  no  direct  drafts. 
The  bed  should  be  placed  where  the  light  will 
not  fall  into  the  baby's  eyes,  and  where  there 
will  be  no  draft.  A  screen  may  be  used  for 
this  purpose.  Some  provision  should  be  made 
for  fresh  air  coming  into  the  room  both  day 
and  night.  Probably  the  best  method  in  cold 
weather  is  by  the  use  of  window  boards,  which 
consist  of  boards  about  six  inches  wide,  an 


THE     NURSERY 


inch  thick  and  long  enough  to  fit  into  the 
width  of  the  window.  The  lower  sash  should 
be  raised  six  inches,  and  the  board  inserted 
across  the  bottom.  The  air  will  then  enter 
between  the  upper  and  lower  sashes  in  suf- 
ficient quantity  to  keep  the  room  w^ell  ven- 
tilated. In  warm  weather,  this  is  not  sufficient. 
Then  the  windows  must  be  kept  wide  open, 
and  it  is  important  to  see  that  each  window  is 
screened  carefully  against  flies  and  mosquitoes. 
Thorough  airing  of  the  nursery  should  take 
place  both  night  and  morning.  During  this  time 
the  baby  may  be  taken  into  another  room. 

Temperature 

The  best  type  of  heating  for  the  nursery  is 
the  open  fire.  When  this  is  not  obtainable, 
and  radiators  or  registers  are  used,  at  least  one 
pan  of  water  should  be  placed  on  the  radiator 
or  register,  so  that  the  air  in  the  room  will  not 
become  too  dry. 

For  the  first  two  or  three  months  of  the 
baby's  life  the  temperature  in  the  nursery 
during  the  daytime  should  be  from  66  to  68 
degrees,  and  from  64  to  65  degrees  at  night. 
This  day  temperature  is  to  be  continued 
through  the  first  year  of  life,  but  after  the 
baby  is  three  months  old  the  night  temperature 
should  be  reduced  to  55  degrees,  and  after  one 
year  of  age  from  45  to  50  degrees  is  proper. 


HE  A L TH Y    BABIES 


The  temperature  should  always  be  read  on 
the  thermometer  which  hangs  at  the  head  of 
the  baby's  crib.  If  the  baby  is  kept  com- 
fortably warm,  has  plenty  of  the  proper  type 
of  bed  clothing,  no  harm  will  be  done  if  the 
night  temperature  goes  below  65  degrees  in 
the  first  three  months  or  below  55  thereafter. 

Lighting 

During  the  first  two  or  three  weeks  of  life 
strong  light  must  be  avoided  in  the  nursery. 
Dark  shades  are  best  to  soften  the  light,  al- 
though the  room  should  not  be  completely 
darkened.  Thereafter  the  ordinary  lighting 
may  be  used  for  the  baby's  waking  hours,  with 
partial  darkness  during  the  sleeping  time. 
Babies  are  peculiarly  sensitive  to  light  and 
sound,  and  for  this  reason  the  room  selected 
for  the  nursery  must  be  where  the  greatest 
amount  of  quiet  may  be  obtained. 

Toys 

Very  young  babies  do  not  need  toys.  When 
they  are  about  three  months  of  age,  and  begin 
to  grasp  objects,  the  simple  rubber  toys  and 
those  made  of  washable  celluloid  mixtures  are 
best.  These  may  be  hung  by  a  string  to  the 
side  of  the  crib  or  baby  carriage,  but  the 
string  should  not  be  long  enough  to  allow  the 
toys  to  reach  the  floor.    Never  hang  toys  from 


THE     NURSERY 


the  cover  of  a  crib  or  carriage  so  that  they 
dangle  in  front  of  the  baby's  eyes.  This  is 
an  exceedingly  bad  custom,  for  it  puts  undue 
strain  upon  the  eyes  of  the  child. 

Young  babies  are  in  the  habit  of  putting 
everything  into  their  mouths.  For  this  reason 
toys  which  cannot  be  washed  are  harmful. 
The  toys  that  are  used  must  be  washed  at 
least  once  a  day,  and  oftener  if  they  fall  on 
the  floor.  Toys  with  bells,  whistles  or  other 
small  ornaments  which  may  become  loose, 
easily  detached  and  possibly  swallowed,  should 
never  be  used  by  young  children. 

When  the  baby  is  teething,  a  cutting  ring 
is  almost  universally  used.  This  may  be  of 
hard  rubber,  celluloid  or  ivory.  There  are 
also  large,  round,  hard  crackers  which  are 
sold  for  this  purpose.  The  ring  should  al- 
ways be  tied  to  the  crib  or  carriage  so  that  it 
cannot  touch  the  floor,  and  when  it  becomes 
soiled  should  always  be  washed  before  being 
used  again  by  the  baby. 

Bahy  Carriages 

The  choice  of  a  baby  carriage  is  important. 
Comfort  is  often  sacrificed  for  the  sake  of 
appearance,  and  here,  as  in  every  other  phase 
of  baby  life,  simplicity  should  be  the  rule. 
The  carriage  should  first  of  all  be  light  in 
weight  and  simple  in  construction,  with  rubber 


H  EA L  TH Y    BABIES 


tires  and  good  springs.  The  hood  or  top 
should  be  arranged  so  that  it  may  be  moved 
in  two  directions — forward  and  back.  The 
fittings  of  the  carriage  when  used  for  a  very 
young  baby,  should  be  a  flat,  firm  pillow  or 
mattress,  covered  with  rubber  sheeting  and  a 
mattress  pad.  The  upper  cover  should  be 
warm,  loose  and  light  in  weight,  the  whole 
fastened  down  with  a  strap  which  keeps  both 
the  baby  and  the  covering  secure  without  any 
undue  pressure.  The  top  should  be  adjusted 
so  that  there  may  be  no  direct  wind  blowing 
on  the  baby's  head,  and  so  that  the  sun  will 
not  shine  into  his  eyes. 

The  low  go-cart  has  many  conveniences. 
It  is  usually  light  in  weight,  easy  to  handle, 
and  may  be  folded  up,  and  put  out  of  the  way 
when  not  in  use.  On  the  other  hand,  it  is 
not  suitable  for  the  very  young  baby  as  it 
forces  the  child  to  sit  too  upright,  and  also 
brings  the  baby  so  close  to  the  ground  that  he 
cannot  be  adequately  protected  from  the  dust 
of  the  street.  The  simple  high  carriage  is 
better  until  the  baby  is  at  least  six  months  old. 

Record  Book 

The  keeping  of  a  record  book  of  the  baby's 
life  has  many  advantages.  Its  drawbacks  are 
mainly  that  the  setting  down  of  information 
relative  to  the  baby's  growth,   progress  and 


THE     NURSERY 


symptoms  may  tend  to  over-accentuate  the 
importance  of  these  items,  and  thus  cause  the 
mother  unnecessary  concern  if  the  record  does 
not  show  constant  improvement.  On  the  other 
hand  such  a  record  may  not  only  be  of  great 
help  to  the  physician,  but  may  also  be  of 
definite  value  to  the  mother. 

Any  blank  book  may  be  used  for  this  pur- 
pose and  each  day's  record,  with  the  date, 
should  be  placed  on  a  separate  page.  Certain 
items,  such  as  weight,  should  be  entered  only 
once  a  week.  The  type  of  feeding  may  be  put 
down  on  a  certain  date  and  thereafter  left 
unrecorded  unless  a  change  is  made.  If  med- 
icine is  given  at  any  time,  or  if  illness  occurs, 
brief  data  regarding  this  may  be  inserted. 
All  changes  in  time  of  feeding  or  character  of 
feeding  should  be  noted. 

Separate  pages  may  be  kept  for  recording 
important  facts  in  the  baby's  life.  A  weight 
chart  similar  to  the  one  given  in  the  back  of 
this  book  should  be  inserted,  and  the  baby's 
weekly  weight  recorded.  Under  the  heading 
of  "growth"  record  may  be  made  of  the  baby's 
length  at  birth,  height  and  chest  measure- 
ments, the  dates  upon  which  he  first  held  up 
his  head,  grasped  for  objects,  sat  upright, 
recognized  father  or  mother,  uttered  the  first 
word,  began  to  creep,  to  stand  alone,  and  other 
important   items.      This   record   often   is   of 


10  HEALTHY    BABIES 

great  help  to  the  physician,  because  of  its 
relation  to  muscular  and  mental  development. 
(See  Record  Sheets  in  back  of  this  book.) 


CHAPTER  II 

GROWTH  AND  DEVELOPMENT 

WEIGHT 

The  average  weight  of  a  baby  at  the  time 
of  birth  is  from  seven  to  seven  and  a  half 
pounds.  The  birth  weight  is  generally  doubled 
at  the  end  of  six  months,  and  trebled  at  the 
end  of  the  first  year.  (See  Weight  Chart  on 
page  206.) 

During  the  first  few  days  of  life  there  is  a 
slight  loss  of  weight  which  may  amount  to 
from  four  to  eight  ounces.  As  soon  as  feeding 
is  established  regularly  a  gain  in  weight  should 
begin,  and  at  the  end  of  ten  days  to  two  weeks 
the  amount  lost  should  have  been  regained 
so  that  the  baby  weighs  the  same  as  at  birth. 
During  the  first  six  months  of  life  the  gain  in 
weight  is  more  rapid  than  during  the  second 
six  months.  It  will  average  from  four  to 
eight  ounces  a  week  while  during  the  second 
six  months  the  weekly  gain  is  from  two  to 
four  ounces.  As  the  baby  grows  older,  the 
gain  each  week  tends  to  lessen  somewhat,  but 
in  general,  the  following  may  be  taken  as  a 
guide : 

1st,  2nd,  3rd  months,  6  to  7  ounces  a  week, 

4th,  5th,  6th  months,  4  to  5  ounces  a  week, 

7th,  8th,  9th  months,  3  to  4  ounces  a  week, 

10th,  11th,  12th  months,  2  to  3  ounces  a  week. 

11 


12  HEALTHY    BABIES 

Bottle  fed  babies  are  less  apt  to  gain  during 
the  first  month.  After  that,  the  increase  in 
weight  is  about  the  same  as  that  of  breast  fed 
babies.  The  gain  in  weight  of  a  baby  is  not 
always  entirely  regular.  Sometimes  the  weight 
will  be  stationary  for  two  or  more  weeks,  yet 
the  baby  will  remain  perfectly  well.  In  bottle 
fed  babies,  this  is  usually  a  sign  that  the  per- 
centage of  milk  in  the  feeding  formula  should 
be  increased.  Stationary  weight  in  breast 
fed  babies  may  be  an  indication  that  supple- 
mentary feeding  is  needed.  Gain  in  weight  is 
less  in  warm  weather.  The  weight  may  be 
stationary  for  two  or  three  weeks  in  the  sum- 
mer without  any  resulting  harm,  and  during 
the  hot  weather  no  attempt  should  be  made 
at  extra  feeding  in  order  to  increase  the  weight. 
Teething  is  also  apt  to  delay  regular  weight 
increase,  and  in  many  babies  there  is  a  period 
dating  from  the  seventh  to  the  tenth  months 
when  weight  may  be  stationary  or  increase 
very  little.  During  the  second  year  the  gain, 
which  averages  about  five  or  six  pounds,  is 
quite  irregular.  It  is  often  interrupted  by 
changes  in  the  weather  or  changes  in  the  type 
of  feeding. 

Weighing 

The  baby  under  six  months  of  age  should 
be  weighed  once  each  week.     From  six  months 


GROWTH    AND     DEVELOPMENT  13 

to  a  year  once  every  two  weeks,  and  from  one 
to  two  years  once  every  month.  This  weighing 
should  take  place  at  the  same  hour,  on  the 
same  day  each  week,  preferably  just  before 
the  bath.  It  is  not  necessary  to  undress  the 
baby  for  the  weighing,  provided  the  same 
number  and  kind  of  clothes  are  worn.  The 
main  point  to  be  remembered  is  not  how  much 
the  baby  weighs,  but  whether  the  gain  is 
regular,  and  of  proper  amount.  Each  baby 
is  a  law  unto  himself,  as  far  as  size  is  con- 
cerned, and  there  is  no  reason  why  a  baby 
who  weighed  five  pounds  at  birth  and  gained 
in  proper  proportion  throughout  the  first  year 
cannot  be  considered  as  healthy  as  the  baby 
who  weighed  ten  pounds  at  birth  and  gained 
in  the  same  proportion. 

Scales 

The  best  type  of  scales  are  expensive. 
The  kind  used  at  the  baby  health  stations 
and  in  hospitals  are  those  with  the  bar  and 
weight  at  one  end  and  a  flat  platform  on  the 
other.  On  this  platform  is  placed  a  flat 
pan  with  only  two  sides.  (See  illustration 
opposite  page  1 9.)  This  is  to  prevent  the  baby's 
falling  off  the  platform  of  the  scale.  The 
ordinary  grocery  scale  is  excellent  for  the 
purpose  of  weighing  the  baby.  If  the  child 
is   small   enough   he   may   be   placed   in   the 


14  HEALTHY    BABIES 

ordinary  scoop.  As  he  grows  older  a  larger 
scoop  or  basket  may  be  substituted,  care  being 
taken  to  see  that  scale  balances  perfectly  when 
it  is  empty.  The  basket  scale  with  dial  at- 
tachment, such  as  is  sold  in  most  baby  fur- 
nishing stores,  is  good  until  the  baby  is  about 
a  year  old,  provided  a  reliable  type  of  scale  is 
purchased.  The  difficulty  with  them,  however, 
is  that  all  scales  which  have  dials  to  indicate 
the  weight  fluctuate  with  the  movement  of 
the  baby  so  that  it  is  difficult  to  record  the 
exact  weight.  The  ordinary  pocket  scale  which 
consists  of  a  nickel  holder  with  a  hook  on  the 
end  is  not  advised  unless  no  other  scale  is 
available.  It  has  the  advantage,  however, 
of  being  very  cheap,  costing  usually  from 
twenty-five  to  fifty  cents.  The  baby  should 
be  placed  in  a  napkin  made  in  the  form  of  a 
sling,  with  the  four  corners  tied  together.  The 
hook  of  the  scale  is  then  placed  in  this  knot 
and  the  baby's  weight  read  on  the  indicator 
of  the  scale. 

Weight  is  the  best  indication  we  have  of  the 
progress  of  the  baby.  Long-continued  station- 
ary weight  or  actual  decrease  in  weight  are 
usually  signs  that  there  is  something  wrong 
with  the  feeding  or  that  the  baby  is  ill. 
Usually  this  is  a  matter  which  requires  ad- 
justment of  the  feeding.  Boys  have  a  tendency 
to  be  a  little  heavier  than  girls,  but,  in  general, 


GROWTH    AND     DEVELOPMENT  15 

not  much  difference  is  noticed  during  the  first 
year. 

HEIGHT 

The  average  height  of  a  new  born  baby  is 
about  twenty  inches.  During  the  first  six 
months  there  is  a  gain  of  about  five  inches. 
During  the  second  six  months  there  is  a  gain 
of  about  three  inches,  so  that  at  the  end  of 
one  year  the  baby  should  measure  about 
twenty-eight  inches  in  length.  During  the 
second  year  the  gain  in  height  is  from  three 
to  four  inches.  Height  is  not  of  much  im- 
portance, because  so  many  other  factors  have 
to  be  taken  into  consideration.  Sometimes  all 
the  members  of  the  family  are  small  in  stature. 
Sometimes  the  race  to  which  the  child  belongs 
always  shows  small  development.  The  point 
to  be  remembered  is  whether  or  not  the  child  is 
keeping  up  its  normal  relation  of  weight  to  its 
height,  rather  than  to  pay  too  much  attention 
to  its  height  alone. 

RELATION  BETV/EEN  SIZE  OF  HEAD  AND  CHEST 

During  the  first  few  years  of  life  the  baby's 
head  alvv^ays  seems  unduly  large  when  com- 
pared with  the  rest  of  the  body.  This  is  a 
normal  condition.  At  birth  the  average  chest 
measurement  is  thirteen  and  a  half  inches 
while  the  head  measures  fourteen  inches  in 


16  HEALTHYBABIES 


circumference.  At  one  year  the  chest  measure- 
ment is  eighteen  inches,  and  the  circumference 
of  the  head,  eighteen  inches.  At  two  years 
the  chest  measures  nineteen  inches,  and  the 
circumference  of  the  head  nineteen  inches. 

MUSCULAR  DEVELOPMENT 

The  normal  baby  should  be  able  to  hold  up 
his  head  without  assistance  at  three  to  four 
months,  and  should  be  able  to  sit  erect,  with 
his  back  unsupported,  between  six  and  seven 
months.  The  first  efforts  to  creep  are  made 
usually  between  the  sixth  and  eighth  months. 
Between  the  ninth  and  tenth  months  the  baby 
tries  to  get  on  his  feet,  and  from  twelve  to 
fourteen  months  should  be  able  to  walk  alone. 
From  fourteen  to  fifteen  months  he  should 
run  about  without  assistance. 

Attempts  to  walk  should  never  be  unduly 
urged,  nor  should  any  effort  be  made  to  allow 
the  baby  to  hold  up  his  head  or  sit  or  stand 
up  before  he  is  able  to  do  so  voluntarily.  It 
must  be  remembered  that  during  the  early 
years  of  life  the  bones  are  soft,  and  must  not 
be  subjected  to  any  strain.  This  is  true  par- 
ticularly of  the  bones  of  the  legs  which,  in  walk- 
ing, must  bear  the  weight  of  the  body.  In- 
ability of  a  child  to  begin  to  walk  at  the  end 
of  a  year  may  be  an  indication  of  some 
nutritional  disorder,  such  as  rickets,   and  if 


GROWTH    AND     DEVELOPMENT  17 

efforts  are  made  to  force  such  a  child  to  walk, 
the  bones  of  the  legs  are  likely  to  bend,  and 
may  become  permanently  deformed.  The 
great  majority  of  cases  of  "bow-legs"  are 
caused  by  children  suffering  from  rickets  being 
allowed  to  walk  at  too  early  an  age. 

The  bones  in  early  childhood  contain  a  very 
small  amount  of  calcium  salts,  so  they  are 
apt  to  be  pliable,  rather  than  brittle.  Frac- 
tures of  the  bones  in  very  young  children  are 
commonly  called  ''greenstick  fractures,"  be- 
cause they  resemble  the  kind  of  break  that 
is  made  when  one  breaks  a  thin  green  stick. 
Frequently  very  little  children  appear  to  be 
bow-legged.  This  is  probably  true  when  they 
first  stand  on  their  feet.  Careful  observation 
will  show  that  in  the  great  majority  of  in- 
stances babies  are  not  bow-legged  at  all.  The 
flesh  on  the  inner  side  of  the  thighs  has  a 
tendency  to  push  the  knees  apart,  and  the 
baby  will  stand  with  the  knees  firmly  planted 
at  a  distance  from  each  other,  so  as  to  main- 
tain his  balance.  The  condition  of  ''bow-legs" 
may  be  said  to  exist  only  when  the  knees  are 
a  considerable  distance  apart,  although  the 
ankles  are  in  contact. 

Some  children  never  creep.  There  are  others 
who  make  every  effort  to  push  themselves 
around  in  this  way.  Creeping  should  not  be 
urged.    Teaching  children  to  walk  by  the  use 


18  HEALTHY    BABIES 

of  contrivances  is  also  to  be  condemned.  The 
child  should  not  be  urged  to  stand,  until  he 
is  ready  to  do  so  voluntarily. 

Not  all  babies  progress  alike  in  their  mus- 
cular development.  There  are  many  things 
which  may  cause  a  child  to  be  slightly  back- 
ward in  this  respect.  Thus,  premature  or 
delicate  infants  develop  slowly.  Severe  or 
long  illness,  rickets,  or  cases  where  babies 
have  had  continued  bowel  or  stomach  disorders 
usually  show  retarded  development.  These 
children  are  not  abnormal.  They  are  simply 
slow.  If  they  regain  their  health  their  tardi- 
ness in  the  matter  of  muscular  development 
is  usually  made  up  in  the  second  year. 

SIGHT 

It  is  probable  that  babies  see  nothing  at  the 
time  of  birth,  although  within  a  very  few  hours 
they  seem  to  distinguish  between  light  and 
darkness.  However,  objects  are  not  recognized 
for  from  six  to  eight  weeks.  At  three  months 
the  baby  will  usually  focus  his  attention,  and 
may  recognize  a  few  people,  such  as  the 
mother  or  nurse.  While  the  baby  will  grasp 
an  article  held  up  to  him  when  he  is  three  to 
four  months  old,  he  does  not  definitely  reach 
out  for  toys  and  recognize  them  until  he  is 
six  months  of  age. 


Proper  Method  of  Measuring  Baby 


cq 


GROWTH    AND    DEVELOPMENT  19 

In  early  life  the  baby  is  particularly  sensi- 
tive to  light  and  should  be  kept  in  a  semi- 
dark  room  for  the  first  two  weeks.  When 
outdoors  or  in  a  bright  light,  the  eyes  should 
always  be  protected  by  holding  the  baby  so 
that  the  light  does  not  shine  directly  into 
them. 

Practically  all  babies  have  blue  eyes  at 
birth.  This  sometimes  changes  during  the  first 
few  weeks  to  what  is  usually  the  permanent 
color.  Many  children  are  cross-eyed  during 
the  first  few  weeks  of  life,  due  to  their  inability 
to  focus  the  eye  muscles.  This  is  merely  a 
temporary  condition,  and  tends  to  get  well  of 
itself.  If  the  cross  eyes  persist  beyond  the 
third  or  fourth  month,  the  advice  of  a  physi- 
cian should  be  secured.  While  crying  is  com- 
mon in  new  born  babies,  tears  are  not.  They 
do  not  appear  until  about  the  third  month. 

HEARING 

Babies  are  deaf  at  birth.  This  is  due  to  the 
mucus  in  the  ear  canal.  The  condition  soon 
clears  up,  however,  and  thereafter  the  baby's 
hearing  is  abnormally  acute.  Sounds  are 
recognized  in  a  few  days,  but  it  is  not  until 
about  two  months  of  age  that  the  baby  is  able 
to  recognize  where  the  sound  comes  from. 
This  sensitiveness  to  sound  is  important,  and 
indicates  the  need  of  quiet  for  babies.     At 


20  HEALTHYBABIES 

about  the  same  time  the  baby  learns  to  recog- 
nize his  parents  by  sight  he  also  recognizes 
their  voices. 

SPEECH 

The  average  baby  is  able  to  say  a  few  words 
at  the  end  of  one  year.  These  are  generally 
the  most  common  words,  such  as  "papa," 
"mamma,"  or  there  may  be  a  definite  recogni- 
tion of  objects  by  giving  them  a  name.  From 
that  time  on  development  in  speech  varies  a 
good  deal  in  different  infants.  Some  children 
learn  to  talk  within  a  very  short  time,  while 
others  are  much  slower.  Usually  a  child  can 
form  short  sentences  at  the  end  of  two  years. 
If  the  baby  is  unable  to  talk  at  all  when  it  is 
two  years  old,  there  are  certain  possibilities 
that  must  be  suspected,  either  that  the  baby 
is  a  mute,  a  deaf  mute,  mentally  backward  or 
actually  mentally  defective.  Occasionally, 
failure  of  speech  is  due  to  some  physical  defect 
in  the  vocal  apparatus.  In  any  event,  if  the 
child  cannot  speak  at  the  end  of  two  years, 
medical  advice  should  be  obtained. 

Closely  allied  to  speech  is  the  expression  of 
pleasurable  emotions.  Babies  will  smile  at  a 
very  early  age,  even  when  only  a  few  days 
old,  but  they  are  not  conscious  of  any  pleasure. 
In  fact,  sometimes  a  little  grimace  or  what 
seems  to  be  a  smile  may  be  caused  by  indiges- 


GROWTH    AND    DEVELOPMENT 


21 


tion.  The  first  smile  of  a  baby  which  may  be 
said  to  reflect  any  feeling  of  well  being  or 
happiness  occurs  at  about  four  or  five  weeks, 
while  the  average  baby  laughs  aloud  between 
four  and  five  months. 

TEETH 

The  first  teeth  are  twenty  in  number  and 
appear  at  fairly  regular  intervals : 


Month, 


No. 
Teeth 


Location 


Ills. 


5-  8 

8-12 

12-18 

18-24 
24-30 


Lower  central  incisors 

Upper  incisors 

Lower  lateral  incisors 

Front  molars,  upper  and  lower .... 
Canine  teeth— upper  jaw  "eyeteeth" 
Canine  teeth — lower  jaw  "stomach 

teeth" 

Back  molars 


See  A 
See  B 
See  C 
SeeD 
See  E 

See  E 
See  F 


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23 


24  HEALTHYBABIES 

The  appearance  of  the  teeth  varies  in 
families  and  sometimes  in  different  babies  in 
the  same  family.  Teething  may  be  delayed 
because  of  long  illness,  rickets,  general  ill- 
health,  undernourishment,  or  because  of  a 
family  trait.  Dentition  is  often  delayed  with 
no  apparent  cause.  Breast  fed  babies  are  apt 
to  have  their  teeth  come  through  earlier  than 
those  who  are  bottle  fed. 

Teething 

Normally,  teething,  or  what  is  known  as 
''dentition"  should  not  cause  any  digestive 
disturbance,  and  if  the  baby  is  suffering  from 
either  stomach  or  bowel  disorders  teething 
should  not  be  looked  upon  as  the  cause,  which 
is  probably  some  wrong  method  of  feeding  or 
wrong  type  of  feeding.  Some  babies  have 
their  teeth  come  through  without  any  dis- 
turbance whatever.  Others  are  apt  to  become 
irritable,  do  not  sleep  well  for  two  or  three 
nights,  there  may  be  slight  loss  of  appetite 
with  some  restlessness  and  occasionally  some 
fever — from  100  to  101  degrees  Fahrenheit. 
A  slight  diarrhea  and  occasionally  vomiting 
may  accompany  dentition,  but  they  tend  to 
clear  up  within  a  very  short  time.  Severe 
cases  of  diarrhea  or  vomiting  are  due  to 
causes  other  than  teething.  The  symptoms 
which  result  from  teething  last  from  three  to 


GROWTH    AND    DEVELOPMENT  25 

four  days.  Then,  as  the  tooth  slowly  pushes 
through,  the  symptoms  subside,  although  the 
baby  may  not  gain  in  weight  for  from  two  to 
three  weeks. 

Treatment  of  Teething 

During  the  period  of  teething,  no  attempt 
should  be  made  to  increase  the  quantity  of 
food,  but  if  there  seems  to  be  much  disturb- 
ance, particularly  diarrhea  or  vomiting,  the 
bottle  fed  baby  should  have  his  food  diluted 
with  from  one-fourth  to  one-third  water  while 
the  breast  fed  baby  should  receive  at  least  a  one 
ounce  bottle  of  water  immediately  after  each 
feeding.  The  baby's  gums  should  be  rubbed 
from  three  to  four  times  a  day,  the  finger  of 
the  mother  or  nurse  being  used  for  this  pur- 
pose. The  hands  must  be  washed  thoroughly 
before  the  finger  is  inserted  into  the  baby's 
mouth.    No  other  treatment  is  necessary. 

Early  Care  of  the  Teeth 

As  soon  as  the  teeth  have  appeared  they 
should  be  washed  three  times  a  day  with  the 
following  method.  A  piece  of  sterile  absorbent 
cotton  should  be  wound  around  the  little 
finger  of  the  mother  or  nurse.  This  should  be 
dipped  in  boric  acid  solution,  and  the  teeth 
wiped  gently  on  all  sides,  using  a  stroking 
motion  from  above  downward  for  the  upper 


26  HEALTHYBABIES 

teeth,  and  from  below  upward  for  the  lower 
teeth.  At  the  end  of  the  second  year  the  teeth 
may  be  brushed  with  a  very  soft  brush,  still 
using  the  boric  acid  solution.  By  the  time 
the  child  is  three  years  old  he  may  be  taught 
to  use  the  toothbrush  himself. 

One  of  the  best  means  of  cleansing  the  teeth 
is  by  mastication.  This  also  makes  them 
stronger,  and  promotes  their  growth.  Fairly 
complete  mastication  is  not  possible  until  the 
child  is  from  fourteen  to  sixteen  months  old, 
but  previous  to  that  time  some  food  other 
than  milk  is  needed.  The  child  may  have  a 
piece  of  dry  bread  or  zwieback  or  a  crust  of 
bread  when  he  is  nine  months  old.  Such  a 
crust  will  take  the  place  of  the  ordinary  teeth- 
ing ring  and  help  relieve  the  irritation  of  the 
gums  caused  by  teeth  that  have  not  yet  come 
through.  Teething  rings  are  not  permissible 
unless  they  can  be  kept  absolutely  clean.  The 
same  may  be  said  of  any  toys  which  the  baby 
may  try  to  put  in  his  mouth. 

Little  babies  have  very  little  saliva.  It 
first  appears  between  the  third  and  fourth 
months,  when  it  is  apt  to  be  rather  excessive. 
In  fact,  the  baby  does  not  swallow  it  all,  but 
allows  a  good  deal  to  run  out  of  the  mouth, 
which  results  in  "drooling."  There  is  nothing 
to  be  done  for  this  condition  except  to  keep 
the  baby  as  clean  as  possible,  and  the  condi- 


GROWTH    AND     DEVELOPMENT  27 

tion  tends  to  correct  itself  as  the  child  grows 
older. 

HEAD 

At  birth  the  baby's  head  has  two  soft  spots, 
one  across  and  just  above  the  brow,  and  about 
one  and  a  half  inches  in  diameter,  the  other 
(much  smaller)  at  the  back  of  the  head  where 
the  bones  join.  These  two  soft  spots  are  called 
the  ''anterior  fontanelle,"  and  the  "posterior 
fontanelle."  The  bones  surrounding  the  pos- 
terior fontanelle  close  in  about  six  weeks.  The 
soft  spot  in  front  of  the  head  persists  and  is 
not  entirely  covered  by  the  bones  until  the 
child  is  about  eighteen  months  old.  If  it 
remains  open  at  the  end  of  two  years  it  is 
probable  that  the  baby  is  affected  with  rickets, 
and  should  receive  medical  attention. 

HAIR 

Many  babies  are  born  with  the  head  cover- 
ed with  hair.  This  is  apt  to  come  out  during 
the  first  few  weeks  or  month.  Occasionally 
babies  will  become  quite  bald  on  the  back  of 
the  head  from  pressure  against  the  pillows. 
New  hair  comes  in  about  as  rapidly  as  the  old 
hair  is  lost.  It  may  or  may  not  be  of  the 
same  color. 

SKIN 

The  baby's  skin  is  quite  pink  at  birth. 
Within  a  short  time  it  changes  to  the  normal 


28  HEALTHYBABIES 

ruddy  color.  The  body  is  covered  with  a  soft 
down  at  birth,  which  soon  disappears.  Per- 
spiration is  not  common  until  the  baby  is 
several  weeks  old.  During  the  first  week  or 
ten  days  there  may  be  a  slight  jaundice,  the 
skin  becomes  yellow.  This  is  not  uncommon, 
and  should  occasion  no  alarm.  Sometimes  the 
skin  of  a  very  young  baby  comes  off  in  fine 
flakes,  leaving  new  skin  underneath.  This 
may  be  the  result  of  a  rash  which  is  due  to 
irritation  by  the  underclothing,  or  too  much 
clothing.     It  needs  no  special  treatment. 

BREASTS 

During  the  first  few  weeks  of  life  the  baby's 
breasts  may  swell  and  become  red.  They  may 
even  secrete  a  small  amount  of  milk.  It  is 
important  not  to  irritate  or  rub  them  during 
this  period.  If  left  entirely  alone  they  will 
usually  get  well,  but  if  rubbed  it  is  possible 
that  abscesses  may  form  and  serious  harm 
result. 

LIFTING  THE  BABY 

Very  young  babies  should  be  handled  as 
little  as  possible,  but  it  is  important  to  remem- 
ber that  they  should  not  remain  in  the  same 
position  for  any  great  length  of  time.  They 
may  be  turned  from  side  to  side  in  their  cribs 
while  they  are  sleeping,  and  this  change  in 


GROWTH    AND    DEVELOPMENT  29 

position  should  be  made  as  often  as  once  every 
hour. 

Young  babies  should  be  lifted  by  placing 
the  left  hand  under  the  baby's  back,  letting 
the  fingers  come  around  to  grasp  the  chest  in 
front  under  the  baby's  left  arm.  The  baby's 
head  will  then  rest  against  the  mother's  left 
forearm.  The  feet  should  be  grasped  with  the 
mother's  right  hand,  and  the  baby  lifted  from 
one  place  to  another  in  this  manner.  (See 
illustration  opposite  page  34). 

In  holding  a  baby,  the  back  and  head  should 
be  well  supported  by  the  mother's  arm,  with 
the  hand  under  the  child's  buttocks.  In  this 
way  the  baby  assumes  a  semi-sitting  position 
and  may  be  carried  about  with  little  difficulty. 
Particularly  after  feeding,  babies  should  be 
lifted  up  over  the  mother's  shoulder  and  held 
firmly  against  her  chest  with  her  arm.  Until 
a  baby  is  at  least  six  months  old,  the  head 
must  be  firmly  supported.  (See  illustration 
opposite  page  35). 

Older  children  should  never  be  lifted  by  the 
hands.  The  best  way  is  to  grasp  them  firmly 
but  lightly  on  either  side  of  the  chest,  under 
the  arms,  and  lift  them  gently  in  this  manner. 

PREVENTION  OF  PROMINENT  EARS 

The  time  to  prevent  prominent  ears  is  in 
early  babyhood.     Care  should  be  taken  that 


30  HEALTHYBABIES 


when  the  child  Hes  on  either  side  of  the  body 
the  ear  is  pressed  flat  against  the  side  of  the 
head.  If  there  is  any  tendency  for  the  ears 
to  be  at  all  prominent,  a  cap  may  be  worn  at 
night.  In  extreme  cases  it  is  permissible  to 
use  tiny  strips  of  adhesive  plaster  to  hold  the 
ears  back  against  the  head,  care  being  taken 
to  see  that  the  tender  skin  is  not  unduly 
irritated.  Continuous  care  and  observation  of 
the  position  of  the  ears  will  usually  result  in 
their  lying  close  to  the  side  of  the  head.  In  a 
few  cases,  measures  of  this  kind  are  not  ef- 
fective. In  such  instances  a  slight  operation 
in  after  life  may  have  to  be  performed  in  order 
to  cure  the  deformity. 

TRAINING  OF  BOWELS  AND  BLADDER 

Training  the  child  to  use  the  chamber  for 
bowel  movements  may  be  commenced  as  early 
as  two  months.  The  best  way  is  to  place  the 
baby  on  a  small  chamber,  with  his  back  sup- 
ported against  the  mother's  knees.  This  should 
be  done  every  morning  at  the  same  time,  pref- 
erably about  one  hour  after  the  first  feeding, 
and  again  one  hour  before  the  evening  feeding. 
If  there  is  any  tendency  towards  constipation 
a  suppository  may  be  used  at  this  time  to 
stimulate  the  bowel  movement.  The  baby 
should   be   held   on   the   chamber   only   five 


GROWTH    AND    DEVELOPMENT  31 

minutes.  It  is  probable  that  in  the  early 
months  the  results  will  not  be  very  satisfactory 
but  occasionally,  within  a  surprisingly  short 
time,  the  child  will  seem  to  realize  why  he  is 
placed  on  the  chamber,  and  will  have  a  bowel 
movement  at  that  time  with  the  utmost  reg- 
ularity. The  habit  of  having  the  bowels  move 
at  the  same  time  each  day  is  not  only  one  of 
the  methods  of  curing  constipation,  but  is  also 
a  great  help  to  the  mother.  Because  of  the 
cleanliness  of  the  diapers,  chafing  is  less  apt 
to  occur,  and  the  regularity  of  the  bowels 
prevents  many  bowel  disorders. 

Training  the  Bladder 

Training  of  the  bladder  is  not  as  easy  as 
training  the  bowels,  but  systematic  attempts 
may  be  made  at  about  three  months  of  age  to 
train  the  child  by  placing  him  on  the  chamber 
four  or  five  times  a  day,  with  his  back  well 
supported.  This  should  be  done  at  regular 
hours,  preferably  immediately  after  feeding. 
While  some  children  take  a  long  time  to  learn 
the  meaning  of  this,  some  learn  very  quickly. 
Passing  of  the  water  may  sometimes  be 
stimulated  by  turning  on  a  faucet  so  that  the 
sound  of  running  water  may  be  heard,  or  a 
cloth  may  be  dipped  in  warm  water  and  gently 
squeezed  over  the  lower  part  of  the  baby*s 


32  HEALTHYBABIES 

abdomen   and   external   genitals.      This   will 
sometimes  stimulate  passing  of  the  urine. 

Suppositories 

In  cases  of  habitual  constipation,  and  oc- 
casionally to  establish  the  habit  of  regular 
bowel  movements,  the  use  of  suppositories  is 
permissible.  In  general,  however,  they  should 
not  be  used  indiscriminately.  Mechanical  aid 
of  this  kind  in  emptying  the  bowels  is  apt  to 
lessen  the  muscular  power  of  the  rectum  and 
if  their  use  is  long  continued  the  result  is  to 
encourage  constipation  rather  than  to  cure  it. 
Occasionally,  however,  suppositories  are  quite 
necessary,  and  in  general  they  are  better  for 
stimulating  bowel  movements  than  the  use  of 
any  drug,  or  even  rectal  enemas.  Suppositories 
may  be  made  by  whittling  out  a  piece  of  pure 
white  castile  soap,  about  the  size  of  a  lead 
pencil,  and  one  and  a  half  inches  in  length. 
The  end  which  is  to  be  inserted  into  the  rectum 
should  be  tapered  off  slightly,  and  the  whole 
moistened  with  warm  water,  then  inserted 
gently  into  the  rectum.  Care  should  be  taken 
that  no  force  is  used.  Gluten  suppositories  and 
those  made  of  cocoa  butter  are  for  sale  in^ 
practically  all  drug  stores,  and  have  the  ad- 
vantage of  being  non-irritating.  If  supposi- 
tories are  to  be   used  with   any  frequency, 


GROWTH    AND     DEVELOPMENT  33 

either  the  gluten  or  cocoa  butter  types  are 
recommended. 

Rectal  Injections 

Injections,  or  enemas  as  they  are  sometimes 
called,  are  useful  in  removing  all  fecal  matter 
from  the  lower  bowel,  but  they  should  not  be 
used  with  any  frequency  or  as  a  regular  method 
of  relieving  constipation.  The  best  method  is 
to  place  the  baby  on  his  left  side,  near  the 
edge  of  the  bed.  A  rubber  sheet  should  be 
placed  under  the  buttocks.  An  ordinary  foun- 
tain syringe  with  a  small  sized  rectal  tip  may 
be  used.  Warm  soapsuds  or  a  solution  of  a 
tablespoonful  of  salt  added  to  a  quart  of  warm 
water  should  be  placed  in  the  bag,  which 
must  be  hung  not  more  than  two  feet  above 
the  level  of  the  baby's  head.  The  rectal  tip 
should  be  greased  with  vaseline,  the  water 
should  be  allowed  to  run  through,  and  the  tip 
should  then  be  inserted  gently  into  the  baby's 
rectum.  Probably  not  more  than  half  a  pint 
of  the  solution  may  be  injected  at  any  one 
time.  The  tube  should  then  be  withdrawn 
gently,  and  the  child's  buttocks  held  firmly 
together  for  a  few  minutes,  causing  the  solu- 
tion to  be  retained  in  the  lower  bowel.  The 
baby  may  then  be  placed  in  an  upright  posi- 
tion on  a  small  chamber  with  his  back  firmly 
supported.    The  water  will  then  be  expelled, 


34  HEALTHYBABIES 

bringing  with  it  some  feces  and  occasionally 
some  gas. 

Irrigation  of  the  Bowels 

Irrigation  of  the  bowels  is  of  great  use  in 
certain  forms  of  bowel  trouble  or  to  remove 
poisonous  or  irritating  matter  from  the  bowels 
when  the  child  has  convulsions. 

Method  of  Giving  Irrigation 

Place  the  baby  on  a  table  or  bed  which  has 
been  covered  with  rubber  sheeting.  The  sheet- 
ing should  extend  over  the  side  of  the  bed  and 
be  brought  together  so  as  to  form  a  trough 
which  reaches  into  a  bowl  placed  on  the  floor 
at  the  side  of  the  bed.  The  child  should  lie 
on  his  back,  with  legs  flexed  and  buttocks  ex- 
tending over  the  edge  of  the  bed  or  table. 
An  ordinary  fountain  syringe  should  contain 
the  solution  to  be  used.  It  is  made  of  soap- 
suds or  a  solution  of  a  tablespoonful  of  salt  to 
a  quart  of  water,  at  a  temperature  of  90 
degrees  Fahrenheit.  The  tube  of  the  syringe 
should  be  connected  with  an  ordinary  soft 
rubber  catheter.  This  may  be  done  by  using 
a  glass  medicine  dropper  which  has  one  end 
inserted  in  the  end  of  the  tube  and  the  other 
in  the  end  of  the  catheter.  The  latter  should 
be  greased  with  vaseline  and  the  water  from 
the  bag  allowed  to  flow  through  it.    As  soon 


Proper  Method  of  Lifting  Baby 


Proper  Method  of  Holding  Baby.      This  Also  Shoius  Card  Board 

Cuff  in  Place 


GROWTH    AND     DEVELOPMENT  35 

as  the  water  begins  to  flow  the  tube  should  be 
pinched  or  bent  and  the  end  inserted  gently 
Into  the  rectum.  The  ankles  of  the  child 
should  be  grasped  and  the  buttocks  lifted  up 
while  the  catheter  is  being  inserted.  Then 
the  water  should  be  allowed  to  flow  in  grad- 
ually. As  it  does  so  it  will  dilate  the  bowels, 
and  the  catheter  may  be  pushed  in.  No  force 
should  be  used  for  this  purpose.  Generally  the 
catheter  can  be  inserted  for  about  ten  to 
twelve  inches.  If  it  is  done  too  hastily  it 
will  turn  on  itself,  and  the  water  will  not  flow. 
After  about  a  pint  of  water  has  gone  into  the 
rectum,  it  will  begin  to  return,  and  should  be 
allowed  to  run  in  through  the  catheter  and 
out  through  the  bow^el  at  the  same  time,  until 
at  least  two  quarts  of  the  solution  have  been 
used.  If  the  bowels  contain  much  feces  it 
may  be  necessary  to  remove  the  catheter  and 
allow  the  bowels  to  move.  It  may  then  be 
inserted  again. 

BAD  HABITS 

Pacifier^ 

The  pacifier  which  is  so  often  used  to  quiet 
babies  not  only  tends  to  the  formation  of  bad 
habits,  but  will  produce  permanent  deformity. 
There  is  every  reason  why  the  pacifier  should 
not  be  allowed.  It  is  practically  impossible 
to  keep  it  clean,  and  a  dirty  article  of  this 


36  HEALTHYBABIES 

kind,  put  into  the  baby's  mouth,  will  almost 
inevitably  carry  with  it  some  form  of  infec- 
tion. The  results  are,  first  of  all,  attacks  of 
colic  which  are  due  to  the  swallowing  of  air, 
and  sore  mouth  which  may  be  due  to  infection 
or  irritation.  More  serious  consequences  are 
the  resultant  thick  lips,  protruding  upper  lip, 
irregular  teeth  and  stimulation  of  the  growth 
of  adenoids. 

Thumb  Sucking  and  Nail  Biting 

These  two  bad  habits  are  comparatively 
common.  Thumb  sucking  will  begin  very  early 
in  infancy,  and  last  throughout  childhood  if 
something  is  not  done  to  prevent  it.  Nail 
biting  occurs  more  often  after  the  first  year. 
The  results  of  thumb  sucking  are  the  same  as 
those  which  come  from  the  use  of  the  pacifier, 
while  the  results  of  nail  biting  are  the  cultiva- 
tion of  a  nervous  habit  and  mutilation  of  the 
fingers  and  nails.  Some  little  babies  will  suck 
the  edges  of  the  blanket  or  twist  at  their 
clothing  and  suck  it. 

Treatment 

The  methods  of  preventing  these  habits 
are  purely  mechanical.  There  are  on  the 
market  types  of  aluminum  hand  mits  which 
have  a  broad  cuff  of  muslin.  These  are  placed 
over  the  baby's  hands,  and  the  cuffs  pinned 


GROWTH    AND    DEVELOPMENT  37 

to  the  baby's  sleeves.  He  can  thus  move  his 
hands  freely,  but  cannot  scratch  his  skin  or 
get  his  fingers  into  his  mouth.  These  mits  are 
excellent  to  use  if  the  child  has  any  skin 
disease  when  it  is  desirable  to  keep  him  from 
scratching. 

Probably  the  best  method  of  preventing 
thumb  sucking  or  nail  biting  is  the  use  of  a 
little  cuff  over  the  elbow.  This  is  made  of  a 
roll  of  cardboard  large  enough  to  slip  easily 
over  the  arm,  and  about  four  or  five  inches 
long.     (See  pattern  on  page  38). 

The  edges  of  the  cardboard  may  be  fastened 
with  adhesive  plaster,  and  the  roll  pinned  to 
the  child's  sleeve,  just  above  the  elbow.  The 
use  of  this  cuff  keeps  the  arm  fairly  stiff,  but 
still  allows  a  slight  motion  of  the  elbow  joint. 
The  child  can  play  perfectly,  but  cannot  put 
his  hands  into  his  mouth. 

The  use  of  drugs  or  bitter  substances  such 
as  quassia  or  aloes  on  the  end  of  the  thumb 
or  fingers  is  not  advised.  While  the  drugs  may 
make  the  child  nauseated,  that  is  generally 
their  only  effect,  and  their  use  seldom  breaks 
up  the  habit. 

Masturbation 

The  practice  of  masturbation  is  not  com- 
mon in  children  less  than  a  year  old,  although 
it  has  been  observed  in  children  under  that 


SJHONI     9    0±    -t^ 


6-0 


38 


GROWTH    AND    DEVELOPMENT       39 

age.  When  the  child  begins  to  walk  about, 
however,  he  may  begin  this  habit  uncon- 
sciously, therefore  its  symptoms  and  treat- 
ment should  be  known. 

The  practice  of  masturbation  consists  in 
irritating  the  genital  organs  by  rubbing  with 
the  fingers,  rubbing  the  thighs  together,  or 
rubbing  the  genital  regions  against  some 
articles.  The  symptoms  noticed  are  that  the 
child's  face  becomes  flushed.  This  is  followed 
closely  by  the  appearance  of  perspiration  on 
the  head  and  forehead.  Later  the  child  be- 
comes drowsy  and  usually  goes  to  sleep.  If 
the  habit  is  repeated  the  child  will  become 
nervous  and  restless,  generally  showing  mark- 
ed irritability.  Sleeplessness  is  common,  and 
frequently  there  are  marked  signs  of  anemia 
and  loss  of  appetite. 

Treatme7tt 

The  treatment  consists  in  the  use  of  thick 
diapers  in  younger  children  so  that  the  genital 
organs  are  protected.  Older  children  should 
be  watched  during  the  daytime.  If  the  habit 
occurs  only  at  night,  it  is  well  to  put  the  child 
to  bed  with  a  little  pillow  between  the  legs 
so  that  there  may  be  no  mechanical  irritation. 
It  must  be  remembered  that  children  do  not 
consciously  form  this  bad  habit  at  so  early 


40  HEALTHY    BABIES 

an  age.  It  is  not  possible,  of  course,  to  use 
any  treatment  or  correction  of  a  moral  nature 
until  the  child  is  older. 


CHAPTER  III 

CLOTHING 

The  main  requisites  for  baby's  clothes  are 
that  they  shall  be  loose,  light  in  weight  and 
that  no  irritating  material  shall  come  into 
contact  with  the  skin.  The  little  body  needs 
freedom  for  growth,  and  muscular  develop- 
ment should  never  be  restricted  by  the  weight 
of  many  garments. 

When  the  baby  is  born,  the  first  outfit 
should  be  ready.  The  number  of  garments 
listed  below  may  be  increased,  if  desired,  but 
those  indicated  should  be  sufficient  for  all 
purposes  during  the  first  year.  With  this 
number  washing  need  not  be  done  more  often 
than  twice  a  week,  except  in  the  case  of  diapers, 
which  must  be  washed  every  day. 

6  Overslips  or  dresses 

4  Gertrude  petticoats 

4  Shirts 

3  Abdominal  bands  for  the  first  month 

3  Knitted  bands  with  shoulder  straps  for  second  to  sixth  months 

4  Nightgowns 

4  Dozen  diapers 

3  Pairs  soft  wool  socks  for  cool  days 

3  Pairs  light  weight  merino  stockings  for  winter 

1  Wrapper 

1  Cloak 

1  Cap 

(See  illustration  opposite  page  50.) 

41 


42  HEALTHYBABIES 

SPECIAL  DIRECTIONS  FOR  MAKING  BABY  CLOTHES. 

Overslips  or  Dresses 

These  should  be  twenty-two  inches  long 
from  neck  to  bottom  of  hem.  There  should 
be  at  least  two  inches  leeway  on  each  side  of 
the  underarm  seam.  Either  in  the  kimono  or 
sleeve  style  of  dress,  the  armhole  should  be 
large  and  the  seam  should  be  opened  and 
sewed  down  or  featherstitched  so  that  it  may 
not  form  a  ridge.  Embroidery  or  lace  should 
not  be  used,  either  on  the  neck  or  on  the 
sleeves,  as  it  may  cause  a  distressing  irritation 
of  the  skin.  For  the  same  reason,  the  baby's 
clothing  should  never  be  starched.  The 
material  for  these  slips  may  be  either  batiste, 
fine  muslin,  nainsook  or  longcloth.  The  neck- 
band and  sleeves  should  be  made  very  wide, 
without  any  trimming.  For  a  new  baby  a 
ten  inch  neckband  is  none  too  wide,  while  the 
cuffs  of  the  sleeves  should  be  wide  enough  so 
that  they  may  slip  on  and  off  over  the  hands 
with  perfect  freedom.  Drawstrings  in  neck- 
band and  cuffs  give  the  best  service,  for  in  this 
way  they  may  be  made  as  loose  or  as  snug  as 
desired.  If  the  dresses  are  made  in  the  man- 
ner described,  it  will  not  be  necessary  to  make 
any  new  short  clothes.  As  the  baby  grows 
the  clothes  will  become  correspondingly  short- 


CLOTHING  43 


er,  and  the  twenty-two  inch  length  should  last 
throughout  the  first  year. 

Change  in  Length  of  Baby  Dresses 

If  dresses  longer  than  the  tw^enty-two  inch 
length  are  used  when  the  baby  is  very  young, 
they  should  be  changed  for  short  ones  when 
the  baby  is  four  months  old.  As  soon  as  the 
baby  begins  to  creep,  one-piece  rompers  are 
advised.  They  may  be  made  of  chambray,  or 
other  easily  washed  material.  In  them  the 
child  can  play  about  as  much  as  he  pleases. 

Petticoats 

The  petticoat  should  be  slightly  shorter  than 
the  dress.  They  are  best  made  in  the  gertrude 
style,  that  is,  not  gathered  in  at  the  waist 
line,  but  made  on  the  lines  of  a  princess  dress, 
fastened  on  each  shoulder  with  two  snap  fast- 
eners. They  are  made  without  sleeves,  and 
with  one  seam  under  each  arm.  In  winter, 
the  gertrude  petticoat  may  be  made  of  all 
wool  flannel,  or,  preferably,  of  cotton  and  wool 
flannel.  In  hot  weather  the  petticoat  need 
not  be  worn. 

Shirts 

The  shirts  should  have  long  sleeves  and  high 
necks.  A  mixture  of  silk  and  cotton,  or  plain 
cotton,  is  advised.    Open  mesh  cotton  goods 


44  HEALTHY    BABIES 


is  excellent  for  underwear.  If  the  baby  is 
undersized  and  delicate,  it  may  be  necessary 
to  use  a  mixture  of  cotton  and  wool  in  the 
underclothes  for  the  first  few  months.  All- 
wool  shirts  are  never  advisable. 

Abdominal  Bands 

These  bands  should  be  made  of  soft,  un- 
hemmed  flannel,  six  inches  wide  by  twenty 
inches  long.  Two  tapes  should  be  sewed  on, 
six  inches  from  one  end.  Two  more  tapes 
should  be  sewed  on,  eight  inches  from  the 
other  end.  After  the  band  is  in  place  the 
opposing  ends  of  the  tapes  should  be  tied 
loosely.  The  tapes  may  be  omitted  and  the 
bands  sewed  on,  but  they  should  never  be 
pinned.  Care  must  be  taken  to  see  that  the 
band  is  not  wide  enough  so  that  it  reaches 
too  high  under  the  arms  or  down  around  the 
thighs,  so  as  to  constrict  the  legs.  It  must 
never  be  wrinkled,  so  as  to  irritate  the  skin, 
nor  must  it  be  fastened  so  tightly  that  there 
will  be  pressure  on  the  baby's  chest  and  ab- 
domen, with  consequent  interference  with  the 
breathing. 

Knitted  Bands 

Flannel  bands  should  be  worn  for  three  or 
four  weeks,  and  may  then  be  changed  for 
knitted  bands.  These  may  be  made  of  silk  and 


CLOTHING  45 


cotton.  Except  in  very  cold  climates,  and  in 
exceptional  cases,  wool  is  not  advised  for 
baby's  underclothing.  It  is  apt  to  be  irritat- 
ing to  the  tender  skin,  and  the  baby  who 
wears  wool  underclothing  may  easily  be  kept 
too  warm.  For  the  new  born  baby  the  second 
size  knitted  band  is  best,  care  being  taken  to 
see  that  there  are  no  rough  seams. 

Stockings 

If  the  baby's  feet  are  warm,  stockings  are 
not  needed.  If  there  is  any  tendency  for 
them  to  become  cold,  however,  soft  knitted 
or  woolen  socks  may  be  used  during  the  first 
few  months.  As  soon  as  the  baby's  dresses 
become  short  enough  so  that  the  feet  are 
exposed,  long  white  merino  stockings,  which 
should  be  pinned  to  the  diaper,  are  advisable. 
When  the  baby  begins  to  walk,  its  feet  should 
be  covered  with  soft  moccasins,  made  with 
the  seams  on  the  outside.  There  should  never 
be  any  pressure  on  the  feet.  Shoes  should 
not  be  worn  until  the  child  is  at  least  one  year 
old,  and  then  only  those  made  of  extremely 
soft  kid,  with  soft,  flexible  soles,  should  be 
worn.  After  the  baby  is  a  year  old,  and  begins 
to  walk,  a  shoe  with  flexible  but  thicker  sole 
is  advised.  All  shoes  must  be  broad,  and  at 
least  one  size  too  long.  Under  no  circum- 
stances should  heels  be  worn.    For  out-of-doors 


46  HEALTHY    BABIES 


in  wet  or  cold  weather,  rubber  or  fleece  lined 
arctics  are  necessary. 

Shoes  with  stiffened  ankles  are  not  advis- 
able. Babies'  muscles  weaken  with  disuse  and 
strengthen  with  use.  If  the  ankles  seem  weak, 
and  the  child  falls  readily  because  of  this  fact, 
the  feet  and  ankles  may  be  massaged  with 
olive  oil  every  night  and  morning,  and  the 
child  encouraged  to  use  them. 

Nightgowns 

Until  a  baby  is  a  month  old,  no  different 
type  of  clothing  is  needed  at  night.  At  the 
end  of  a  month,  the  child  should  be  undressed 
at  night,  and  given  an  entire  change  of  cloth- 
ing. The  nightgowns  should  be  at  least  thirty- 
two  inches  in  length,  long  enough  to  reach  at 
least  ten  inches  below  the  feet.  A  very  good 
type  for  winter  use  is  the  one  with  drawstring 
in  the  hem,  or  the  one  which  folds  over  at  the 
bottom  and  fastens  with  snaps.  Such  night- 
gowns keep  the  baby's  feet  warm  and  allow 
him  to  kick  without  having  the  nightgown 
pull  up  around  the  body.  When  the  age  is 
reached  where  rompers  are  worn  in  the  day- 
time, night-drawers  with  feet  attached  will 
be  found  comfortable  at  night.  The  night- 
gowns may  be  made  of  wool  flannel  or  a 
mixture  of  cotton  and  wool.  In  hot  weather, 
muslin  is  advisable. 


CLOTHING  47 


Diapers 

The  diapers  used  during  the  first  two  or 
three  months  should  be  18  x  36  inches  in  size. 
Later  those  22  x  44  inches  will  be  found  more 
comfortable.  They  should  be  made  of  cotton 
birdseye.  Small  squares  of  cloth  of  several 
thicknesses  may  be  placed  inside  the  diaper 
to  receive  the  discharges  from  the  bowels. 
These  cloths  should  be  thrown  away  as  soon 
as  they  are  soiled,  and  their  use  will  save  much 
laundry  work. 

Rubber  Drawers  or  Rubber  Diapers 

The  use  of  rubber  drawers  or  rubber  dia- 
pers is  not  advised,  although  there  are  some 
instances  in  which  their  use  seems  unavoid- 
able. If  the  baby  is  taken  on  a  journey,  or  to 
a  place  where  his  diaper  cannot  be  changed 
for  several  hours,  a  rubber  diaper  may  be  placed 
over  the  regular  diaper  in  order  that  the  rest 
of  the  clothing  may  not  become  soiled.  The 
rubber  drawers,  which  are  usually  made  of 
oilskin  or  thin  rubber  tissue,  are  used  for  a 
similar  purpose.  The  use  of  any  watertight 
article  of  this  kind  means  that  the  air  is 
practically  excluded  from  the  baby's  skin,  and 
in  addition  the  parts  are  allowed  to  remain  in 
contact  with  the  urine  and  feces  for  an  undue 
length  of  time,  thus  causing  a  marked  irrita- 


48  HEALTHY    BABIES 

tion  of  the  skin,  therefore  rubber  drawers  or 
rubber  diapers  should  not  be  used  except  in 
case  of  great  emergency,  and  then  only  for 
short  periods  of  time. 

Wrapper,  Cloak  and  Cap 

These  should  be  made  in  accordance  with 
the  needs  of  the  weather.  A  silk  cap  lined  with 
flannel  is  advised.  This  is  soft  and  warm,  but 
light  in  weight.  The  wrapper  may  be  made 
of  flannel  or  lightly  padded  silk.  A  small 
knitted  shawl  or  blanket,  about  a  yard  square, 
is  useful  for  wrapping  loosely  about  the  baby 
during  the  first  month. 

Difference  Between  Summer  and 
Winter  Clothing 

The  indoor  clothing  during  the  entire  first 
year  should  not  vary  with  the  seasons,  either 
in  kind  or  in  amount.  The  actual  temperature 
of  the  day,  not  the  time  of  year,  is  the  guide 
in  deciding  how  much  clothing  the  baby  should 
wear.  In  winter,  the  outer  clothing  must  be 
sufficient  to  give  warmth  without  weight. 
Over-dressing  of  young  children  is  a  tendency 
that  must  be  guarded  against.  Babies  are 
very  sensitive  to  heat,  and  too  heavy  clothing 
may  be  the  cause  of  illness.  Much  more 
harm  is  done  by  too  much  clothing  than  by 
too  little. 


CLOTHING  49 


Clothes  are  of  proper  weight  when  the  baby 
is  comfortable.  The  best  indication  is  the 
presence  or  absence  of  perspiration  and  the 
temperature  of  the  hands  and  feet.  If  the 
baby  needs  extra  covering  in  the  house,  a  soft 
knitted  jacket  may  be  put  on.  When  it  seems 
wise  to  use  a  blanket,  it  must  not  be  wrapped 
too  tightly.  Continuous  pressure  against  the 
child's  body  is  harmful.  When  the  baby  or 
young  child  is  taken  out-of-doors  in  winter, 
a  sweater  and  long  drawer-leggings  may  be 
put  on  over  the  indoor  clothing,  in  addition 
to  the  cap  and  coat.  All  such  extra  clothing 
should  be  removed  as  soon  as  the  child  comes 
indoors. 

In  the  summer,  if  the  weather  is  warm  or 
hot,  the  baby  needs  to  be  dressed  only  in  his 
undershirt,  diaper  and  outside  slip.  On  cool 
days,  the  flannel  gertrude  petticoat  may  be 
added.  Remember  that  babies  suffer  from 
heat  more  than  adults  do,  and  their  clothing 
must  be  extremely  light  in  weight  whenever 
the  temperature  goes  over  eighty  degrees. 

How  to  Dress  the  Baby 

It  is  best  to  place  the  baby  on  some  flat 
surface  when  dressing  him,  such  as  a  bed  or 
low  table,  which  should  be  covered  with  a 
soft  blanket.  In  this  way  the  baby  is  more 
easily  and  safely  handled,  and  the  mother  has 


50  HEALTHY    BABIES 

much  greater  freedom  of  action  than  if  she 
used  her  lap  for  this  purpose. 

The  band  is  put  on  first.  It  must  never 
be  tight.  It  should  be  tied  on  one  side  or 
sewed  over  and  over  with  large  stitches  of 
coarse  white  thread.  Next  comes  the  shirt, 
then  the  diaper,  which  is  to  be  pinned  firmly 
with  large  safety  pins  to  the  front  and  back 
of  the  shirt.  Next  the  stockings,  and  finally 
the  flannel  petticoat  and  slip  should  be  pulled 
on  over  the  baby's  feet.  They  should  never 
be  put  on  over  his  head.  With  a  little  practice, 
very  little  turning  of  the  baby  is  necessary, 
provided  the  clothing  is  placed  conveniently 
at  hand.  It  is  well  to  have  all  the  clothing 
ready  on  a  rack  so  that  it  may  be  available 
as  soon  as  the  baby  has  finished  his  bath  and 
is  ready  for  the  daily  dressing. 


Baby  Clothes 
1.    Shirt.      2.    Gertrude    Petticoat.      3. 
Shoulder    Straps.     Jf.    Abdominal    Band 
Diaper.     6.  Socks.     7.  Overslip  or  Dress. 


Knitted    Band     With 
for    First    Month,     d. 


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O 


CO 


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c-^ 


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CHAPTER  IV 

BATHING 

During  the  first  ten  days  of  life  the  baby 
may  be  given  only  sponge  baths.  The  tub 
bath  must  not  be  used  until  the  cord  has 
dropped  off,  and  the  navel  entirely  healed. 

Equipment  for  Bathing  the  Baby 

The  following  equipment  is  needed  for  the 
baby's  bath: 

A  rubber  sheet,  36  inches  square,  to  place  over  the  lap  of  the 

mother  or  nurse. 
A  portable  bathtub,  which  should  be  placed  upon  a  low  stool. 
Two  basins,  one  for  warm  and  one  for  cool  water. 
A  soft  blanket  upon  which  to  place  the  baby  after  he  is  removed 

from  the  water. 
Several  old,  soft  cotton  or  linen  towels. 
Two   sets   of  washcloths.     The    different   sets   may  vary   in 

material,  but  both  should  be  soft.     One  set  is  to  be  used  for 

the  face  and  head,  and  the  other  for  the  rest  of  the  body. 

They  may  have  borders  of  different  colors  so  they  may  be 

easily  distinguished  from  each  other. 
A  bath  thermometer. 
A  tumbler  of  boric  acid  solution  (for  method  of  preparation 

see  "Nursery  Remedies,"  page  182.) 
Absorbent  cotton. 
Castile  soap. 
Talcum  powder. 

Temperature  of  the  Room 

The  room  in  which  the  bath  is  to  be  given 
should  be  kept  at  about  70  degrees  Fahrenheit. 
Drafts  must  be  avoided.     If  there  is  an  open 

51 


52  HEALTHYBABIES 

fireplace,  the  bathing  equipment  should  be 
arranged  in  front  of  it,  and  the  bath  given 
there.  (See  illustrations  opposite  pages  51 
and  66.) 

Temperature  of  the  Water 

For  the  first  few  weeks  the  temperature  of 
the  bath  should  be  100  degrees  Fahrenheit. 
From  the  first  to  the  third  months  it  may  be 
reduced  to  98  degrees.  After  six  months  it 
should  be  95  degrees.  During  the  second  year 
the  bath  may  be  given  at  a  temperature  of  from 
85  to  90  degrees.  (See  illustration  opposite 
page  66.) 

Time  of  Bath 

The  bath  should  preferably  be  given  in  the 
morning,  at  least  one  hour  before  feeding. 
If  more  convenient,  the  daily  bath  may  be 
given  at  night.  The  point  to  be  remembered 
is  that  after  the  bath  the  baby  should  be  fed, 
and  then  put  into  his  crib  to  sleep. 

Method  of  Giving  Bath 

Fill  the  bathtub  two-thirds  full  of  water. 
Undress  the  baby  by  placing  him  on  his  stom- 
ach. Unbutton  the  clothing  in  back,  turn  him 
over  once  and  remove  the  clothing  down  over 
the  feet.  The  band  and  shirt  may  then  be 
taken  off  easily.  The  baby  should  be  wrapped 
immediately  in  a  flannel  apron. 


BATHING  53 


Sponge  Bath 

For  the  sponge  bath  during  the  first  ten 
days,  the  two  basins  should  be  used,  both 
filled  with  warm  water  at  the  temperature 
mentioned.  Only  one  part  of  the  body  should 
be  washed  at  a  time:  first,  the  head,  face  and 
ears  should  be  washed  with  a  soft  cloth,  using 
soap  and  water,  then  rinsed  off,  using  the 
second  cloth  and  the  other  basin  of  water  for 
this  purpose.  Care  must  be  taken  to  see  that 
the  soap  does  not  get  into  the  baby's  eyes. 
The  face  and  head  should  then  be  patted 
dry  gently  with  a  soft  towel.  After  that  each 
part  of  the  body  in  turn  should  be  covered 
with  a  little  soap  rubbed  on  the  washcloth, 
and  then  rinsed  off  with  water  from  the  second 
basin.  Each  part  should  be  dried  by  patting 
gently  before  another  part  is  washed. 

As  soon  as  the  cord  has  dropped  off,  the 
tub  bath  may  be  given. 

Tub  Bath 

The  proper  method  is  to  wash  first  the  face, 
head  and  ears  in  the  manner  already  de- 
scribed. The  body  should  then  be  rubbed  all 
over  with  soap  and  water,  the  back  and  head 
of  the  baby  being  supported  with  the  left  hand 
of  the  mother  or  nurse,  and  the  ankles  grasped 
with  the  right  hand,  thus  placing  the  baby  in 


54  HEALTHYBABIES 

a  semi-reclining  position.  It  should  then  be 
lowered  gently  into  the  tub  and  washed  gently 
until  all  the  soap  has  been  removed.  The 
baby  must  not  be  left  in  the  tub  longer  than 
three  or  four  minutes.  Prolonged  bathing  is 
not  desirable.  The  child  is  then  lifted  out  of 
the  tub  in  the  same  manner,  and  placed  on  a 
towel  placed  over  the  rubber  apron  on  the 
mother's  lap,  covered  immediately  with  the 
towel  and  gently  patted  dry.  The  skin  of 
young  babies  must  never  be  rubbed. 

After  the  baby  is  completely  dry,  a  good 
powder  such  as  talcum,  or  a  mixture  of  equal 
parts  of  starch  and  talcum  powder,  should  be 
sprinkled  lightly  over  the  body,  particularly 
in  the  folds  of  the  skin  and  around  the  genitals. 

When  the  Tub  Bath  Should  Not  Be  Used 

Very  delicate  or  feeble  babies  usually  do 
not  react  well  to  tub  bathing,  and  in  such 
cases  the  sponge  bath  should  be  used  instead. 
This  is  true  also  of  babies  suffering  from 
eczema  or  other  skin  diseases,  when  water 
often  irritates  the  skin.  A  physician's  advice 
should  be  obtained  about  bathing  a  baby  who 
has  a  skin  disease  or  irritable  skin.  A  daily 
rubbing  with  olive  oil  is  sometimes  helpful, 
or  the  special  baths  may  be  used  as  hereafter 
described. 


BATHING  55 


Care  of  the  Genital  Organs 

Particular  care  must  be  taken  of  the  but- 
tocks and  genitals,  because  they  become  chafed 
so  easily.  They  must  be  washed  after  each 
wetting  or  movement,  and  then  covered  light- 
ly with  powder.  Diapers  must  not  be  used  a 
second  time  without  being  washed.  If  chafing 
occurs,  it  may  be  necessary  to  see  that  the 
parts  are  not  wet  at  all,  until  they  are  healed. 
In  such  cases  the  baby  may  be  given  a  sponge 
bath.  The  genitals  are  to  be  cleaned  with 
olive  oil  or  sweet  oil,  and  a  little  absorbent 
cotton  after  each  movement,  then  covered 
with  starch  or  talcum  powder  or  powdered 
stearate  of  zinc.  The  latter  is  particularly 
good  because,  besides  adhering  closely  to  the 
skin,  it  is  waterproof  and  very  soothing.  In 
boys,  particular  care  must  be  used  to  see  that 
secretion  or  other  foreign  substances  do  not 
collect  in  the  foreskin.  The  foreskin  should 
be  pushed  back  gently  twice  a  week,  no  force 
being  used.  If  there  is  any  irritation  of  the 
foreskin  or  penis,  or  if  the  foreskin  cannot  be 
pushed  back  easily,  a  doctor  should  be  con- 
sulted. 

Circumcision 

Indications  that  circumcision  is  needed  are 
difficulty  in  passing  urine,   irritation  of  the 


56  HEALTHY    BABIES 

penis  or  inability  to  push  back  the  foreskin. 
The  matter  of  whether  or  not  circumcision  is 
indicated  should  always  be  left  for  the  physi- 
cian to  decide.  It  is  possible  sometimes  for 
the  latter  to  stretch  the  foreskin  so  that  it  may 
be  retracted,  but  this  must  never  be  tried  by 
anyone  other  than  a  physician. 

Care  of  the  Diapers 

The  diaper  is  an  important  part  of  the 
baby's  wardrobe.  If  it  is  adjusted  properly 
and  kept  clean,  it  adds  much  to  the  comfort 
and  health  of  the  baby.  In  putting  on  the 
diaper,  remember  that  it  should  not  be  tight 
around  the  stomach  or  legs.  If  any  ridges 
are  seen  at  these  places  when  the  diaper  is 
removed,  it  is  a  sure  sign  that  there  has  been 
too  much  pressure.  A  diaper  that  has  been 
soiled  must  never  be  used  a  second  time  with- 
out being  washed.  Soiled  diapers  should  be 
removed  immediately,  the  baby's  buttocks 
and  genitals  washed  gently  with  soap  and 
water  or  cleansed  with  olive  oil,  and  then 
dusted  with  talcum  powder.  The  diapers 
should  be  placed  at  once  in  a  pail  of  cold  water, 
which  must  be  kept  covered.  Once  a  day 
the  diapers  should  be  rinsed  out,  then  boiled 
in  soapsuds  for  thirty  minutes,  rinsed  thor- 
oughly, and,  if  possible,  dried  in  the  sunlight 
in  the  open  air. 


BATHING  57 


Care  of  the  Eyes 

At  the  time  of  the  bath  the  eyes  should  be 
washed  with  a  piece  of  absorbent  cotton,  wet 
with  boric  acid  solution  which  is  gently 
squeezed,  allowing  the  solution  to  drip  into 
the  baby's  eyes.  The  child  should  be  placed 
on  the  right  side  when  the  right  eye  is  being 
washed,  and  on  the  left  side  when  the  left  eye 
is  being  washed.  The  point  to  be  remembered 
is  that  the  solution  should  always  drain  from 
the  nose  to  the  outer  side  of  the  face,  so  that 
there  may  be  no  contamination  of  one  eye 
from  the  secretions  of  the  other.  The  absor- 
bent cotton  that  has  been  used  once  should 
never  be  replaced  in  the  boric  acid  solution, 
but  a  fresh  piece  must  be  used  each  time.  If 
the  lids  of  the  eyes  are  stuck  together,  the 
edges  may  be  greased  with  a  small  quantity  of 
white  vaseline.  If  there  is  any  secretion,  a  doc- 
tor should  be  consulted  without  delay,  as  ap- 
pearance of  this  pus  may  indicate  the  presence 
of  a  very  serious  disease  of  the  eyes,  which  in 
some  cases  leads  on  to  permanent  blindness. 

Care  of  the  Nose,  Mouth  and  Ears 

No  attention  need  be  paid  to  the  nose  unless 
secretion  is  noticed.  Then  the  nostrils  may 
be  cleansed  gently  by  twisting  bits  of  cotton 
into  tiny  pledgets,  and  wiping  out  carefully 


58  HEALTHYBABIES 

that  part  of  the  nostril  which  is  visible.  No 
force  should  be  used,  nor  should  any  toothpick 
or  other  instrument  be  applied. 

The  baby's  mouth  should  not  be  washed 
out  at  all,  except  under  the  doctor's  direction. 
If  milk  seems  to  remain  in  the  mouth  after 
feeding,  one  or  two  teaspoonfuls  of  water 
given  to  the  baby  will  rinse  it  out  and  provide 
all  necessary  cleanliness. 

The  ear  canal  may  be  cleansed  occasionally 
by  wiping  gently  any  excess  wax  from  around 
the  opening.  Here  again  no  instrument  should 
ever  be  inserted,  as  serious  danger  may  result 
from  any  such  procedure. 

Care  of  the  Umbilicus  or  Navel 

Before  the  cord  falls  off,  care  must  be  taken 
that  the  dressing  does  not  become  wet  un- 
necessarily. It  need  not  be  removed  every 
day,  but  if  any  sign  of  secretion  is  shown  it 
may  be  necessary  to  remove  the  old  dressing, 
cover  the  stump  of  the  cord  with  boric  acid 
powder  and  apply  a  new  dressing.  If,  after 
the  cord  has  fallen  off,  there  is  a  tendency  for 
the  navel  to  protrude,  a  pad  of  cotton  may 
be  placed  over  it,  under  the  abdominal  binder. 
If  this  does  not  remedy  the  trouble,  a  more 
permanent  dressing  of  adhesive  plaster  should 
be  used.  This  is  prepared  by  taking  a  strip 
of  adhesive  plaster  two  inches  wide  and  eight 


BATHING  59 


inches  long.  In  the  center  place  a  cent,  a  quar- 
ter or  a  smooth  button  which  is  considerably 
larger  in  size  than  the  protrusion.  Over  this 
place  a  small  strip  of  adhesive  plaster  with  the 
adhesive  side  next  to  the  article,  so  that  it 
may  be  covered  completely,  and  the  plaster 
at  that  spot  will  not  adhere  to  the  baby's  skin. 
The  strip  should  then  be  placed  so  that  the 
coin  or  button  will  come  directly  over  the 
protrusion  of  the  navel,  which  must  be  pressed 
back  gently  while  the  band  is  being  adjusted. 
The  adhesive  strip  may  then  be  drawn  firmly 
across  either  side  of  the  baby's  abdomen.  This 
will  remain  in  place  for  a  considerable  period  of 
time,  and  usually  is  little  affected  by  water,  al- 
though prolonged  tub  baths  are  not  advised 
while  it  is  worn.  After  it  has  served  its  pur- 
pose it  may  be  removed  by  the  use  of  alcohol 
or  ether  or  by  scrubbing  with  soapsuds. 

Nails 

There  is  no  reason  why  a  baby's  nails  should 
not  be  cut.     It  is  better  to  keep  them  short. 

Warm  and  Cool  Baths 

The  warm  bath  should  be  used  as  a  sedative. 
It  cleanses  the  skin  and  keeps  it  active  so 
that  the  waste  of  the  body  is  eliminated.  It 
reduces  nervous  symptoms,  and  is  excellent 
when  the  child  is  restless  and  unable  to  sleep. 


60  HEALTHYBABIES 

The  cool  bath,  on  the  contrary,  is  stimulating 
and  should  not  be  given  just  before  sleeping 
time  except  in  very  hot  weather. 

Alcohol  Baths 

In  case  of  fever  or  in  very  hot  weather,  an 
alcohol  bath  is  refreshing.  Two  tablespoon- 
fuls  of  alcohol  are  added  to  a  basin  of  water  at 
a  temperature  of  about  75  degrees  Fahrenheit. 
The  methods  given  for  a  sponge  bath  should 
be  followed.  Alcohol  baths  may  be  given  two 
or  three  times  in  twenty-four  hours. 

Bran  Baths 

These  baths  are  of  particular  value  in  the 
case  of  babies  with  delicate  skin,  or  those 
suffering  from  prickly  heat.  A  cupful  of  bran 
should  be  put  in  a  cheesecloth  bag,  and  then 
squeezed  in  a  tub  of  water  until  the  latter  is 
of  a  milky  color.  The  temperature  of  the 
water  should  be  from  90  to  95  degrees  Fahren- 
heit. The  baby  is  to  be  placed  in  the  bath  for 
three  or  four  minutes  and  bathed  gently. 
There  should  be  no  hard  rubbing,  and  no  soap 
should  be  used. 

Soda  Baths 

For  bad  prickly  heat  which  does  not  yield 
to  the  bran  bath,  or  in  case  of  hives,  a  soda 
bath    may    be    used    with    some    temporary 


BATHING  61 


benefit.  Two  heaping  tablespoonfuls  of  bak- 
ing soda  should  be  put  in  a  tub  of  water,  and 
the  same  method  of  bathing  used  as  has  been 
outHned  for  bran  baths. 

Mustard  Bath 

In  case  of  a  sudden  convulsion  in  a  baby, 
the  mustard  bath  is  a  first  aid.  A  level  table- 
spoonful  of  mustard  should  be  mixed  in  a  cup 
of  water  until  it  is  free  from  lumps.  Then  it 
should  be  stirred  thoroughly  into  a  tubful  of 
water  at  a  temperature  of  100  degrees  Fahren- 
heit. Care  must  be  taken  that  none  of  the 
flakes  of  mustard  are  left  floating  in  the  water, 
as  they  are  apt  to  irritate  the  baby's  skin  and 
cause  burns. 

A  bath  of  this  kind  should  be  of  about  five 
minutes  duration.  When  the  baby  is  taken 
out  he  must  be  wrapped  immediately  in  a 
flannel  blanket  with  a  hot  water  bag  placed 
at  his  feet.  There  are  other  methods  of  treat- 
ing convulsions,  such  as  seeing  that  the  bowels 
are  emptied  at  once  by  means  of  an  enema  or 
an  injection,  but  the  mustard  bath  is  a  family 
remedy  of  first  importance.  Convulsions  in  a 
baby  are  apt  to  terrify  the  young  mother,  so 
she  should  know  what  to  do  at  once.  Re- 
member that  this  bath  may  relieve  the  symp- 
toms, but  cannot  be  relied  upon  as  a  cure. 
Send  for  the  doctor  as  quickly  as  possible. 


62  HEALTHY    BABIES 

Salt  Baths 

Salt  baths  are  cooling,  and  in  certain  cases 
of  delicate  skin  can  be  used  when  the  ordinary 
soap  and  water  bath  is  inadvisable.  They  are 
prepared  by  adding  a  teacupful  of  sea  salt  to 
two  gallons  of  water.  They  may  be  given 
either  in  the  tub  or  as  sponge  bath. 

Baths  for  Older  Children 

As  soon  as  the  baby  is  old  enough,  let  him 
take  part  in  the  bathing  process.  Babies 
usually  enjoy  being  in  the  water,  and  as  they 
grow  older,  the  splashing  about  and  helping 
to  bathe  themselves  is  not  only  fun,  but  helps 
them  to  an  appreciation  of  the  comfort  of  the 
daily  bath,  and  this  is  one  of  the  life  habits 
that  is  especially  health-giving. 


CHAPTER  V 

FRESH  AIR,  SLEEP  AND  QUIET, 
EXERCISE 

FRESH  AIR 

Fresh  air  is  as  essential  as  food  for  the 
growing  baby.  Fortunately  it  is  one  of  the 
necessities  that  is  within  the  reach  of  every- 
one. Air  not  only  gives  babies  many  of  the 
elements  that  are  needed  for  their  growth,  but 
its  action  on  the  body  aids  in  the  elimination 
of  some  of  the  waste  products.  The  growing 
child  needs  much  more  pure  air  in  proportion 
to  its  size  than  the  adult  does,  just  as  it 
needs  more  food  in  proportion  to  its  size, 
therefore  it  is  important  that  babies  should 
become  accustomed  just  as  early  as  possible 
to  being  outdoors  or  in  a  thoroughly  venti- 
lated room  the  greater  part  of  the  day. 
Mothers  sometimes  think  they  cannot  take 
their  children  outdoors  often,  because  they 
take  cold  if  they  go  out-of-doors  frequently. 
Fresh  air  prevents  colds;  it  does  not  give 
them.  An  abundance  of  good  air  makes  the 
digestion  better,  improves  the  appetite,  and 
in  every  way  conduces  to  good  health.  The 
delicate  child  needs  fresh  air  even  more  than 
the  healthy  baby  does. 

63 


64  HEALTHYBABIES 

Indoor  Airing 

The  nursery  should  be  kept  thoroughly 
ventilated  from  the  time  the  baby  is  born. 
To  do  this,  one  of  the  best  ways  is  to  open  the 
window  slightly  at  top  and  bottom,  using  a 
window  board  in  the  lower  sash.  The  room 
should  be  kept  as  nearly  as  possible  at  a 
temperature  of  from  65  to  68  degrees,  and  the 
thermometer  from  which  the  temperature  is 
read  should  be  placed  on  the  wall  at  the  head 
of  the  child's  bed. 

Temperature  of  Sleeping  Room 

The  temperature  of  the  nursery  at  night 
should  never  be  higher  than  sixty  degrees. 
This  may  be  reduced  gradually,  and  the  baby 
may  sleep  in  an  unheated  room  after  it  is  six 
weeks  old  if  care  has  been  taken  to  accustom 
him  to  the  low  temperature. 

Methods  of  Indoor  Airing 

When  the  weather  is  extremely  cold,  with 
rain  or  snow,  sharp  winds  or  melting  snow  on 
the  ground,  it  is  best  to  give  the  baby  his 
airing  indoors.  To  do  this  he  should  be  dressed 
in  the  same  way  as  if  he  were  going  out,  then 
placed  in  the  baby  carriage  with  the  usual 
warm  robes  over  him.  If  it  is  very  cold  out- 
doors it  is  advisable  to  use  a  hot  water  bag  at 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        65 

his  feet.  The  windows  in  the  room  should 
then  be  opened  wide,  and  the  door  closed  so 
there  will  be  no  direct  draft.  The  baby  may 
be  wheeled  about  the  room  or  left  near  the' 
open  window,  if  the  wind  is  not  too  strong. 
Care  must  be  taken  that  the  sun  does  not  shine 
into  the  baby's  eyes.  For  the  first  airing 
indoors,  fifteen  minutes  is  long  enough.  After 
that  the  time  may  be  increased  gradually 
until  it  covers  at  least  two  hours,  both  in  the 
morning  and  afternoon. 

Otit-of-Doors 

In  summer  and  in  warm  climates,  the  baby 
may  be  taken  out-of-doors  at  the  end  of  one 
week.  During  the  cool  days  of  spring  and  fall, 
the  outdoor  airing  is  best  postponed  until  the 
baby  is  a  month  old.  In  the  winter,  much 
depends  upon  the  severity  of  the  weather. 
If  the  days  are  mild,  the  baby  may  be  taken 
out  at  the  end  of  one  month ;  if  the  weather  is 
severe,  it  is  best  to  wait  until  the  child  is  two 
months  old.  The  outdoor  airing  is  not  ad- 
vised until  the  child  is  five  months  old  when 
the  weather  is  below  the  freezing  point,  and 
it  is  equally  unwise  to  allow  a  child  less  than 
a  year  old  to  play  outdoors  if  the  temperature 
is  below  20  degrees. 

When  a  little  child  is  taken  out-of-doors  in 
a  carriage,  care  must  be  taken  to  see  that  his 


66  HEALTHYBABIES 

hands  and  feet  are  warm.  On  the  other  hand, 
there  should  not  be  so  many  clothes  that  the 
child  will  become  overheated,  for  this  is  one 
of  the  surest  ways  of  catching  cold.  The  best 
time  for  a  baby  to  be  taken  outdoors  depends 
upon  the  season.  In  the  winter  and  early 
spring,  between  10  a.  m.  and  3  p.  m.  is  the 
best  time.  In  summer  and  early  autumn,  care 
must  be  taken  that  the  baby  does  not  go  out 
in  the  heat  of  the  day,  unless  there  is  a  shady 
place  or  a  porch  that  is  protected  from  the 
sun  where  he  may  stay.  It  is  necessary  also 
to  see  that  the  baby  is  not  placed  where  there 
are  any  strong  winds.  In  summer,  the  crib 
or  carriage  should  be  carefully  protected  with 
mosquito  netting. 

Sleeping  Outdoors 

In  climates  that  are  mild  or  fairly  mild, 
babies  may  become  accustomed  to  sleeping 
outdoors  at  night  from  the  time  they  are  a 
month  to  six  weeks  old.  However,  this  a 
matter  which  must  be  adjusted  to  the  in- 
dividual needs  and  to  the  weather  conditions. 
The  baby  should  not  sleep  out  if  the  weather 
is  very  cold,  or  if  there  is  rain  or  snow,  or 
high  winds.  Except  in  bad  weather  it  is  an 
excellent  thing  to  accustom  children  to  sleep- 
ing outdoors  as  early  as  possible,  and  the  baby 
can  sleep  out,  sick  or  well,  if  it  is  properly 


Clinical  Thermometer  and  Bath  Thermometer 


Home  Made  Hess  Refrigerator 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        67 

clothed.  A  low  temperature  induces  calm 
sleep.  The  baby  will  then  keep  under  the  bed 
clothes,  and  is  less  apt  to  be  restless.  Out-of- 
door  sleeping  is  particularly  good  for  nervous 
children. 

SLEEP  AND  QUIET 

The  new-born  baby  sleeps  nearly  all  the 
time.  For  the  first  two  or  three  months  he 
may  sleep  as  much  as  twenty-two  hours  out 
of  the  twenty-four,  and  up  to  six  months  of 
age  he  should  sleep  eighteen  hours  out  of  the 
twenty-four.  After  six  months,  the  normal 
baby  will  sleep  from  six  o'clock  in  the  evening 
to  six  o'clock  in  the  morning  without  awaking, 
and  at  this  time  a  two-hour  nap  in  the  fore- 
noon and  afternoon  are  necessary.  Care  should 
be  taken  that  the  afternoon  nap  does  not  end 
later  than  three  o'clock,  otherwise  the  baby 
will  not  go  to  sleep  again  at  six  o'clock.  At 
the  beginning  of  the  second  year  it  will  be 
necessary  to  omit  the  forenoon  nap. 

How  to  Put  the  Baby  to  Sleep 

The  baby  should  always  sleep  alone  on  a 
bed  with  firm  mattress,  preferably  of  hair,  a 
thin  pillow,  and  bed  clothing  that  is  light  and 
warm,  but  of  little  weight.  After  the  baby  is 
in  bed  the  outer  bed  clothing  should  not  be 
tucked  in  too  tightly.     It  is  best  to  leave  it 


68  HEALTHYBABIES 

rather  loose,  and  pin  it  down  at  the  sides  to 
the  mattress  with  large  safety  pins  made  for 
this  particular  purpose.  In  this  way  there 
will  be  plenty  of  room  for  kicking  about  and 
freedom  of  action,  yet  the  bed  clothing  will 
not  be  thrown  off. 

After  the  last  feeding  at  night,  with  the 
appetite  satisfied,  the  baby  should  be  put  to 
sleep  in  a  dark,  well-ventilated,  quiet  room, 
then  left  alone.  While  emphasis  has  been 
placed  upon  the  need  of  a  quiet  room  for  the 
baby,  it  must  be  remembered  that  the  or- 
dinary house  noises  may  go  on  as  usual,  for 
there  is  no  reason  why  the  presence  of  a  baby 
should  disturb  the  ordinary  household  routine, 
provided  loud,  sharp  and  unusual  noises  are 
avoided.  The  baby  may  readily  become  ac- 
customed to  the  ordinary  noises  of  life  from 
the  time  of  birth,  and  it  is  much  better  that 
this  should  be  so.  Loud  and  unusual  noises, 
however,  will  almost  always  awaken  the  baby, 
for  the  sleep  of  early  infancy  is  light,  although 
it  may  be  continuous  and  quiet.  The  heavy 
sleep  that  is  so  noticeable  in  childhood  does 
not  occur  much  under  three  years  of  age. 

Normal  Sleep 

The  healthy  baby  never  sleeps  too  much. 
Such  sleep  is  usually  quiet  and  regular,  the 
breathing  is  even,  the  baby's  color  good,  and 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        69 

there  are  no  sudden,  jerky  movements  of  the 
body.  The  normal  baby  usually  awakens  at 
the  regular  feeding  time.  If  not,  he  should 
be  taken  up  and  fed  when  the  proper  time 
arrives.  If  the  baby  awakens  before  the  feed- 
ing time,  it  is  probable  that  the  food  was  too 
weak.  A  little  water  may  be  given,  but  the 
regular  feeding  schedule  should  be  maintained. 
If  this  is  persisted  in,  within  a  short  time  the 
baby  will  sleep  regularly  between  the  feeding 
periods,  except  for  the  one  hour  allowed  for 
the  bath  and  the  half  to  one  hour  for  the 
crying  which  is  such  a  necessary  part  of  the 
baby's  daily  exercise. 

The  baby  should  not  be  allowed  to  sleep  on 
his  back.  He  should  be  turned  from  side  to 
side  at  fairly  frequent  intervals,  although  there 
is  no  reason  why  the  mother  should  try  to  do 
this  during  the  night  as  long  as  the  baby  is 
sleeping  comfortably. 

Sleeplessness 

One  of  the  greatest  causes  of  difficulty  in 
getting  a  child  to  sleep  is  the  formation  of  bad 
habits,  such  as  rocking,  the  use  of  a  pacifier, 
or  taking  him  out  of  bed  when  he  cries.  If  he 
is  put  in  a  cool,  quiet  room  and  left  alone  he 
will  establish  the  habit  early  in  life  of  going  to 
sleep  by  himself.  Occasionally,  babies  will 
cry.     If  the  mother  is  sure  there  is  nothing 


70  HEALTHYBABIES 

wrong,  he  should  be  left  to  cry  it  out.  This 
may  last  an  hour,  and  in  extreme  cases  even 
two  or  three  hours,  but  while  the  struggle  is 
exceedingly  hard  to  bear  for  a  night  or  two, 
if  he  is  left  alone,  and  no  attention  is  paid  to 
him,  he  will  soon  learn  that  he  is  expected  to 
go  to  sleep  at  this  time,  and  will  act  accord- 
ingly. 

Less  frequent  reasons  for  restlessness  are 
putting  the  baby  to  sleep  in  a  lighted  room  or 
a  room  with  bad  air,  hunger,  thirst,  indigestion 
due  to  the  wrong  kind  of  food  or  irregular 
hours  of  feeding,  over-feeding,  wet  diapers, 
too  heavy  or  insufficient  bed  clothing  or  phys- 
ical discomfort  due  to  cold  feet,  colic  or  pain 
or  the  pricking  of  an  unfastened  safety  pin. 
Frequently  babies  remain  awake  because  they 
were  played  with  before  going  to  bed,  a  habit 
which  not  only  tends  to  sleeplessness,  but 
which  is  one  of  the  surest  ways  of  creating 
extreme  nervousness.  All  of  these  causes  are 
easily  removed,  and  can  be  avoided  with  a 
little  forethought. 

There  are  other  causes  of  sleeplessness, 
which  depend  upon  actual  physical  disease, 
and  are  therefore  more  serious.  The  child  may 
have  enlarged  tonsils  or  adenoids  which  in- 
terfere with  breathing,  so  that  he  is  extremely 
restless  during  sleep.  He  may  be  below  nor- 
mal in  vitality,  suffering  from  malnutrition  or 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        71 

anemia,  or  his  sleeplessness  may  be  caused  by 
scurvy,  syphilis  or  tuberculosis  of  the  hip  or 
spine,  which  cause  severe  pains  at  night. 

Treatment  of  Sleeplessness 

If  the  difficulty  is  one  of  physical  discomfort, 
the  baby  should  be  taken  up,  examined,  made 
comfortable  and  then,  if  found  to  be  all  right, 
left  alone  until  he  acquires  the  habit  of  sleeping 
regularly.  However,  if  the  difficulty  seems  to 
be  a  physical  disease,  which  can  be  deter- 
mined only  if  the  crying  persists  night  after 
night,  notwithstanding  everything  that  is  done 
to  make  the  baby  comfortable,  and  if  he  is 
being  trained  for  good  habits,  a  physician 
should  be  consulted  and  his  advice  taken  re- 
garding the  care  of  the  child. 

Prevention  of  Nervousness 

The  basis  of  a  large  part  of  the  nervousness 
which  occurs  later  in  life  is  laid  in  infancy. 
Adults  generally  do  not  realize  the  extreme 
instability  of  the  nervous  system  of  a  baby. 
So  much  harm  may  be  done  by  lack  of  care  in 
the  first  few  months  of  life  that  special  atten- 
tion should  be  paid  to  the  necessity  of  keeping 
the  little  baby  free  from  undue  excitement. 
There  is  no  reason  why  the  child  should  not 
be  accustomed  to  the  ordinary  household 
noises,  but  for  the  greater  part  of  the  twenty- 


72  HEALTHY    BABIES 

four  hours,  the  baby  should  be  allowed  simply 
to  eat  and  sleep,  have  his  ordinary,  normal 
exercise,  and  should  be  taken  up  only  by  the 
mother,  for  that  essential  mother  care  which 
is  so  necessary  for  the  full  development  of  any 
child.  Throughout  the  period  of  infancy  every 
effort  must  be  made  to  see  that  the  baby's 
nervous  equilibrium  is  undisturbed.  There 
should  be  no  undue  excitement,  and  no  special 
stimulation  of  the  baby,  but  there  should  be 
as  much  quiet  and  rest  in  peaceful  surround- 
ings as  the  family  can  possibly  provide.  The 
things  which  are  particularly  to  be  avoided 
are  undue  playing  with  little  children,  tossing 
or  jumping  them  up  and  down,  sudden  and 
abrupt  noises  to  awaken  them,  or  to  attract 
their  attention,  tickling  them  to  make  them 
shriek,  stimulating  them  to  laughter  by  sudden 
noises,  shaking  or  any  other  form  of  boisterous 
play.  If  it  is  necessary  to  awaken  the  baby 
at  any  time,  it  should  be  done  by  passing  the 
hand  gently  back  and  forth  across  the  fore- 
head.    He  will  then  awaken  quite  naturally. 

All  of  this  does  not  mean  that  the  mother 
should  not  take  her  baby  in  her  arms  at  fre- 
quent intervals.  This  is  essential,  and  such 
attention  ^and  mother  care  are  absolutely 
necessary  for  the  baby's  growth  and  even  his 
life,  but,  with  the  exception  of  the  mother,  the 
father  or  the  nurse,  there  may  well  be  a  rule 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        73 

in  the  household  that  the  baby  is  not  to  be 
handled  by  anyone.  Many  instances  of  acute 
nervousness  in  childhood  are  directly  trace- 
able to  failure  to  adhere  to  this  policy  during 
the  baby's  first  year  of  life. 

EXERCISE 

Exercise  is  essential,  but  the  normal  baby 
does  not  need  any  help  in  this  regard.  He 
will  generally  get  enough  by  perfectly  natural 
means.  The  only  aid  he  needs  is  the  assurance 
of  perfect  freedom  of  action.  This  is  one  of 
the  reasons  why  the  baby's  clothing  should 
not  be  tight.  In  early  infancy,  perfect  free- 
dom to  move  about  and  kick  should  be  allowed 
for  at  least  half  an  hour  twice  a  day.  If  the 
weather  is  warm,  or  if  the  room  can  be  kept 
at  an  even  temperature  of  about  68  degrees, 
the  baby  may  be  undressed  except  for  his  shirt, 
stockings  and  napkin,  and  one  little  overslip. 
In  very  hot  weather  nothing  but  the  napkin 
need  be  kept  on.  If  he  is  put  on  a  clean  bed, 
or  on  a  clean  blanket  spread  on  the  floor,  he 
will  exercise  by  himself  as  much  as  is  necessary. 
During  this  time  he  should  be  left  alone.  He 
do^  not  need  entertaining,  and  the  kind  of 
exercise  he  gets  will  be  far  more  helpful  if  he 
gets  it  alone. 

From  the  time  of  birth  it  is  necessary  that 
the  baby  does  not  remain  too  long  in  one 


74  HE  ALTHY    B  ABIES 

position.  He  should  be  picked  up  and  carried 
about  several  times  a  day,  and  at  all  times  the 
bed  clothes  should  be  loose  enough  so  that  he 
may  have  perfect  freedom  of  action  while  in 
bed.  Carrying  the  baby  about  is  a  passive 
form  of  exercise,  yet  one  that  is  particularly 
needed  in  the  case  of  weak,  malnourished  or 
sickly  infants.  Such  babies  must  not  be  left 
lying  in  one  position  for  any  considerable 
length  of  time.  They  are  too  weak  to  provide 
their  own  exercise,  and  therefore  must  be 
carried  about  in  order  to  get  some  physical 
change.  In  addition,  such  babies  should  be 
exercised  twice  a  day  by  being  given  a  mild 
form  of  massage,  which  is  really  nothing  more 
than  gentle  rubbing  with  olive  oil  or  cocoa 
butter.  This  may  be  done  best  after  the  bath 
in  the  morning  and  the  last  thing  before  the 
baby  is  put  to  bed  at  night. 

While  no  baby  should  be  induced  to  walk 
at  too  early  an  age,  there  is  equal  danger  in 
using  the  baby  carriage  too  long,  and  thus 
retarding  walking.  The  average  baby  will 
make  efforts  to  creep  at  six  months.  Usually 
the  first  attempt  to  stand  alone  will  be  made 
at  about  nine  to  ten  months,  and  a  month  or  so 
afterwards  the  first  step  should  be  taken 
alone.  Walking  should  never  be  unduly  urged. 
The  baby's  bones  at  this  time  of  life  are 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        75 

pliable,  and  if  weight  is  put  upon  the  leg  bones 
at  too  early  an  age  bow  legs  are  apt  to  result. 

Little  children  should  not  be  allowed  to 
romp  just  before  their  bedtime,  nor  should  the 
baby  be  played  with  except  before  feeding  in 
the  middle  of  the  morning  or  the  middle  of 
the  afternoon.  As  soon  as  the  child  is  old 
enough  to  go  out-of-doors  the  ordinary  run- 
ning about,  use  of  the  shovel  and  sand  pile, 
and  other  simple  amusements  will  furnish  all 
the  exercise  necessary.  In  fact,  it  is  never 
necessary  to  stimulate  any  normal  child  to 
play.  The  normal  baby  is  hardly  quiet  a 
moment  during  his  waking  hours,  and  may  be 
trusted  to  develop  his  muscles  in  the  way  that 
Nature  intended.  The  problem  of  the  older 
child  is  one  of  trying  to  keep  it  quiet,  rather 
than  stimulating  it  to  play. 

CRYING 

A  certain  amount  of  crying  is  a  normal 
process  in  baby  life.  At  least  one  good  lusty 
cry  a  day  should  be  expected  during  the  first 
months.  The  normal  cry  is  the  baby's  method 
of  exercising.  It  fills  the  lungs  with  air,  pro- 
motes deep  breathing,  and  in  every  way  is 
stimulating  and  helpful.  If  the  baby  does 
not  cry  it  may  be  necessary  to  make  him  do  so. 
However,  any  prolonged  crying  in  early  in- 
fancy usually  has  some  definite  cause.     It  is 


76  HEALTHY    BABIES 

difficult  to  describe  the  different  types  of 
cries,  but  once  heard,  they  are  seldom  for- 
gotten, and  there  are  few  mothers  with  any 
experience  whatever  in  baby  care  who  cannot 
tell  exactly  the  nature  of  the  baby's  cry. 

The  Normal  Cry 

The  commonplace,  normal  cry,  which  is 
simply  the  baby's  method  of  getting  exercise 
for  his  lungs,  is  loud,  strong  and  apt  to  be 
continuous.  The  baby  may  stop  to  draw  a 
deep  breath  once  in  a  while.  Sometimes  the 
cry  develops  into  a  scream,  and  the  baby 
will  become  red  in  the  face.  As  has  been 
stated,  this  cry  is  necessary  to  health,  and 
can  be  disregarded  unless  it  lasts  for  an  un- 
due length  of  time. 

The  Abnormal  Cry 

There  are  many  types  of  abnormal  cries, 
and  it  is  necessary  for  the  mother  to  be  able 
to  distinguish  between  them  so  that  she  may 
know  the  types  which  need  attention  and 
those  which  need  cause  no  concern. 

Habit  Cry 

The  most  common  cry  of  infancy  is  that 
which  is  due  to  habit,  which  means  the  desire 
to  obtain  some  particular  object,  or  because 
the  baby  has  found  that  he  will  receive  some 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        77 

unusual  attention  if  he  only  cries  for  it.  It 
must  be  remembered  that  during  early  infancy 
crying  is  the  only  method  the  baby  has  of 
attracting  attention,  and  if  he  gets  what  he 
wants  when  he  cries  for  it  he  will  learn  almost 
immediately  that  he  can  satisfy  his  desires 
in  this  way.  There  are  many  things  a  baby 
wants  and  will  cry  for.  It  may  be  rocking, 
to  be  carried  about,  to  have  a  light  in  the 
room,  to  have  a  bottle  or  any  other  thing 
that  seems  desirable.  This  crying  is  charac- 
teristic. It  is  short,  sharp  and  screaming  in 
character,  and  stops  at  once  when  the  baby 
gets  what  he  wants. 

Cry  of  Anger 

This  is  due  to  fits  of  temper.  The  cry  is 
strong,  very  loud  and  violent  in  character. 
The  baby  kicks  and  throws  his  whole  body 
about.  There  may  be  marked  stiffening  of  the 
body  or  the  child  may  hold  his  breath  for  so 
long  a  time  that  the  face  gets  blue,  and  the 
mother  becomes  worried  for  fear  the  baby  will 
strangle.  The  temper  cry  is  much  like  the 
habit  cry,  in  that  it  often  ceases  when  the 
baby  gets  his  desire.  On  the  other  hand, 
some  babies  cry  for  temper  alone,  and  for  no 
particular  reason  that  can  be  ascertained. 
The  treatment  of  the  temper  cry  and  the 
habit  cry  is  to  let  the  baby  cry  it  out.     This 


78  HEALTHYBABIES 

may  take  from  one  to  three  hours.  If  the 
child  is  shut  off  in  a  quiet,  well  ventilated  room, 
and  is  made  perfectly  comfortable,  the  mother 
need  not  be  at  all  concerned  that  anything 
wrong  will  happen.  There  is  no  danger  of  the 
baby  becoming  ruptured  if  a  well  fitted  band 
is  worn  during  the  first  month  and  the  ordinary 
knitted  band  for  the  rest  of  the  first  year. 
There  is  never  any  danger  of  a  child  becoming 
ruptured  from  crying  after  he  is  a  year  old. 
This  treatment  may  seem  very  trying,  but  if 
persisted  in,  the  crying  periods  will  become 
shorter  and  shorter,  until  they  cease  altogether. 

Cry  of  Hunger 

The  hunger  cry  is  a  fretful,  continuous  cry. 
It  is  sometimes  in  the  nature  of  a  whimper, 
never  very  loud,  in  no  way  resembling  the 
lusty  cry  of  temper.  The  hunger  cry  stops  as 
soon  as  the  baby  is  fed,  but  immediate  feeding 
is  wrong  as  a  method  of  treatment.  If  the 
baby  cries  from  hunger  before  his  regular 
feeding  time,  it  is  an  indication  that  the  food 
is  too  weak,  and  that  it  should  be  increased  in 
strength.  Under  no  circumstances  should  the 
hours  of  feeding  be  changed. 

Cry  of  Indigestion 

One  of  the  common  cries  of  infancy  is  that 
of  colic  or  indigestion.     It  is  much  like  the 


FRESH    AIR,    SLEEP,    QUIET,    EXERCISE        79 

cry  of  hunger,  and  if  gas  is  expelled  and  there 
is  any  vomiting,  or  if  the  abdomen  is  hard 
and  tense,  it  is  probable  that  the  cry  is 
due  to  indigestion  or  colic.  If  not,  it  may 
be  considered  as  due  to  hunger.  These  two 
types  of  crying  must  be  carefully  differen- 
tiated, because  while  feeding  the  hungry  baby 
may  result  simply  in  forming  a  bad  habit, 
feeding  the  baby  who  is  crying  because  of 
indigestion  or  colic  makes  the  condition  very- 
much  worse. 

Cry  of  Pain 

There  are  frequently  other  indications  of 
pain  besides  the  cry,  but  the  latter  is  charac- 
teristic. It  is  sharp,  strong,  and  apt  to  oc- 
cur in  spasmodic  outbursts.  The  baby  is  very 
apt  to  draw  up  his  legs,  toss  about  on  the 
bed  and  show  other  symptoms  of  marked 
distress,  while  the  face  and  features  are  fre- 
quently contracted.  This  cry  of  pain  is  fre- 
quently a  symptom  of  sickness.  When  it  oc- 
curs at  night,  it  is  apt  to  be  an  indication 
that  the  baby  has  some  definite  disease  such 
as  scurvy,  syphilis,  or  an  acute  bone  disease; 
therefore,  if  this  type  of  crying  is  persistent 
for  any  length  of  time,  or  if  it  occurs  at 
night,  the  advice  of  a  physician  should  be 
obtained. 


80  HEALTHY    BABIES 

Cry  of  Illness 

There  is  rarely  any  doubt  about  this  type  of 
cry.  It  can  hardly  be  called  a  cry  at  all.  It 
is  rather  a  long,  continuous  moaning  or  whin- 
ing noise.  It  comes  from  great  physical  dis- 
comfort, and  occurs  frequently  when  children 
are  seriously  undernourished,  have  low  vitality 
or  when  they  are  suffering  from  some  chronic 
disease.  All  of  these  conditions  require  med- 
ical attention. 

Other  Kinds  of  Crying 

Children  may  cry  from  a  variety  of  causes 
— wet  diapers,  cold  feet,  cramped  position, 
wrinkled  bed  clothing,  too  tight  clothing,  too 
much  or  too  little  bed  clothing,  or  because 
they  are  actually  suffering  from  the  pricking 
of  an  unclasped  safety  pin.  All  of  these  mat- 
ters are  easy  to  adjust,  because  removal  of  the 
cause  will  stop  the  crying.  The  treatment  of 
ordinary  night  crying  is  the  treatment  given 
for  restless  sleep,  when  neither  is  due  to  definite 
illness.  The  baby  should  be  made  comfortable, 
the  clothing  smoothed,  hands  and  feet  warm, 
napkin  dry,  any  source  of  irritation  removed, 
the  room  well  ventilated  and  darkened,  and 
the  baby  then  left  alone. 


CHAPTER  VI 

FEEDING 

BREAST   FEEDING 

Unless  there  is  some  direct  indication  to  the 
contrary,  every  mother  should  nurse  her  baby. 
If  she  has  taken  proper  care  of  herself  during 
the  prenatal  period,  and  if  she  continues  to 
keep  herself  in  good  physical  condition,  there 
is  no  reason  why  her  milk  should  not  be  suf- 
ficient and  proper  for  the  baby's  needs.  As 
far  as  the  baby's  health  is  concerned,  there  is 
no  argument  against  breast  feeding  and  every 
reason  why  it  should  be  carried  out.  The 
mother's  milk  is  the  natural  food  for  her  baby. 
It  is  always  adjusted  to  the  baby's  age  and 
needs,  and  is  clean,  fresh,  sterile  and  whole- 
some. The  breast  fed  baby  is  much  less  likely 
to  become  ill  than  is  the  bottle  fed  baby.  His 
bones  are  stronger,  his  muscles  firmer,  and  his 
teeth  much  more  apt  to  be  normal  and  to 
come  through  at  the  proper  time.  If  the 
breast  fed  baby  does  become  sick,  his  chances 
of  recovery  are  far  greater  than  those  of  the 
bottle  fed  infant. 

There  are  other  reasons  why  breast  feeding 
is  desirable,  as  far  as  the  comfort  of  the  mother 
is  concerned.  There  is  no  need  to  prepare  the 
milk,  or  to  be  apprehensive  about  changing 
the  kind  of  milk.  No  matter  where  the  mother 


81 


82  HEALTHYBABIES 

and  baby  go,  the  food  question  need  cause  no 
concern.  There  is  no  real  substitute  for  the 
mother's  milk.  When  breast  feeding  is  im- 
possible, the  best  we  can  do  is  to  try  to  find 
some  type  of  feeding  which  will  agree  with  the 
baby,  but  this  substitution  always  involves 
difficulty  and  readjustment,  and  the  mother 
who  nurses  her  baby  is  not  only  giving  him  the 
best  chances  for  life  and  health,  but  is  estab- 
lishing between  herself  and  her  child  a  bond 
which  should  not  lightly  be  set  aside.  It  is 
probable  that  about  95  per  cent  of  all  mothers 
can  nurse  their  babies  if  they  wish  to  do  so. 
It  must  be  acknowledged,  however,  that 
there  are  certain  instances  when  it  is  unwise 
for  the  mother  to  begin  or  to  continue  breast 
feeding,  and  these  must  be  considered. 

When  Breast  Feeding  is  Undesirable 

Breast  feeding  should  not  be  attempted  by 
a  mother  who  is  suffering  from  disease  of  the 
heart  or  kidneys,  or  from  some  chronic  disease 
which  is  lowering  her  vitality.  Tuberculosis 
and  mental  disease  in  the  mother  are  also 
contra-indications  for  breast  feeding.  If  the 
baby  is  extremely  feeble  or  has  been  born 
prematurely,  it  may  not  be  possible  to  carry 
on  breast  feeding  at  first,  although  in  such 
instances  the  baby  will  thrive  better  on  milk 
which  has  been  milked  out  of  the  mother's 


FEEDING  83 


breast  and  then  fed  through  a  medicine  drop- 
per. If  the  mother  becomes  pregnant  again, 
that  also  is  a  reason  why  she  should  stop 
breast  feeding,  as  it  may  be  a  serious  drain 
upon  her  vitality.  The  fact  that  she  is  men- 
struating, however,  is  no  reason  why  breast 
feeding  should  be  stopped.  A  change  should 
not  be  made  to  bottle  feeding  simply  because 
her  milk  does  not  seem  to  agree  with  the  baby. 
The  trouble  probably  is  with  the  mother  and 
can  usually  be  adjusted  if  she  pays  particular 
attention  to  her  diet  and  habits.  If  the  milk 
seems  to  disagree  with  the  baby  for  any 
length  of  time,  however,  and  such  readjust- 
ment cannot  be  made,  the  doctor's  advice 
should  be  obtained,  and  change  made  to  bottle 
feeding  only  if  he  recommends  it.  During  a 
short  acute  illness  the  milk  may  be  pumped 
from  the  mother's  breast  and  fed  to  the  baby 
without  harm. 

Difficulty  in  Nursing 

From  the  point  of  view  of  the  mother,  dif- 
ficulty in  nursing  is  usually  due  to  soreness  of 
the  nipples.  This  may  be  because  proper  care 
has  not  been  taken  of  them  during  the  prenatal 
period.  If  there  should  be  an  abscess  of  the 
breast  that  also  is  a  reason  why  it  may  be 
extremely  painful  for  the  mother  to  nurse 
her  baby,  but  it  is  not  a  reason  why  the  baby 


84  HE  ALTHY    B  ABIES 

should  be  weaned  as  long  as  the  other  breast 
is  secreting  milk.  On  the  part  of  the  baby  the 
reasons  for  difficulty  in  nursing  are  extreme 
feebleness  or  some  physical  deformity,  such  as 
hare-lip  or  cleft  palate.  For  the  feeble  baby, 
milk  may  be  given  through  a  medicine  dropper, 
and  it  is  probable  that  some  similar  method 
will  have  to  be  used  in  the  case  of  the  child 
with  deformity  of  the  mouth.  The  latter, 
however,  should  receive  the  attention  of  a 
physician  at  the  earliest  possible  moment. 

Care  of  the  Nipples  and  Breast 

The  utmost  cleanliness  must  be  observed 
with  regard  to  the  nipples  and  breast  of  the 
nursing  mother.  They  should  never  be  touch- 
ed with  hands  that  have  not  been  washed 
immediately  before.  The  mother  should  avoid 
wearing  corsets  which  are  too  high  and  which 
press  against  the  breast,  but  should  support 
pendulous  or  drooping  breasts  with  a  well- 
shaped  brassiere  or  breast  binder.  Immedi- 
ately before  and  immediately  after  nursing, 
the  nipples  should  be  washed  gently  with 
boric  acid  solution,  and  between  nursings 
they  should  be  kept  covered  with  sterile 
gauze.  If  there  is  any  tendency  for  the 
nipples  to  crack  the  best  treatment  is  to 
cover  them  with  zinc  oxide  ointment,  which 
should  be  left  on  between  feedings,  and  then 


FEEDING  85 


removed  carefully  with  boric  acid  solution 
before  the  baby  is  put  to  the  breast.  If  the 
nipples  are  extremely  painful  it  may  be  neces- 
sary to  use  a  nipple  shield.  Some  babies  do 
not  take  kindly  to  such  shields,  and  it  may  be 
necessary  to  milk  the  breast  for  a  moment  or 
so  until  some  of  the  milk  has  flowed  into  the 
shield,  so  that  the  baby  may  get  it  directly 
from  the  nipple.  Then  he  can  continue  to 
nurse  without  difficulty.  If  the  nipple  is 
cracked  and  bleeding,  the  baby  should  not 
nurse  from  it,  but  a  breast  pump  may  be  used 
to  obtain  the  milk,  which  later  may  be  fed  to 
the  baby  from  a  bottle. 

Hygiene  of  the  Nursing  Mother 

The  life  of  the  nursing  mother  should  be  as 
normal  as  possible.  There  is  no  particular 
diet  that  can  be  recommended.  The  foods 
that  have  agreed  with  her  previously  should 
be  continued,  but  it  is  well  to  avoid  rich  foods, 
highly  seasoned  gravies  or  soups,  pastries  and 
similar  articles  of  diet.  Eight  hours  sleep  at 
night  is  desirable,  with  a  nap  in  the  middle  of 
the  day  whenever  possible.  There  should  be 
at  least  one  hour's  exercise  twice  a  day,  pref- 
erably in  the  form  of  walking.  Late  hours, 
worry  and  excitement  must  be  avoided.  There 
is  nothing  will  interfere  more  with  the  pro- 
duction   of    milk    than    nervousness    or    any 


86  HEALTHYBABIES 

marked  emotion.  A  calm  mind  is  as  necessary 
as  a  healthy  body  in  promoting  a  proper 
supply  of  breast  milk.  Tea  or  coffee  need 
not  be  eliminated  altogether,  but  may  be 
taken  in  moderation.  Cocoa  and  milk  are 
better,  if  they  agree  with  the  mother.  Care 
must  be  taken  to  keep  the  bowe  3  open  and 
regular.  Bran  biscuits,  whole  wheat  bread, 
stewed  fruits  at  the  evening  meal  and  fresh 
fruits  in  the  morning  all  are  excellent  for  this 
purpose. 

Nursing  Habits 

During  the  first  two  days  the  baby  should 
be  put  to  the  breast  every  four  hours.  During 
this  time  he  will  get  only  the  colostrum  from 
the  mother's  breast,  but  no  food  in  addition 
is  needed.  One  and  a  half  ounces  of  warm 
water  should  be  given  him  from  a  nursing 
bottle  at  lea  ^t  once  every  four  hours,  and  may 
be  given  once  every  three  hours  if  he  is  restless. 
At  the  end  of  forty-eight  hours  the  regular 
feeding  schedule  may  be  commenced.  It  is 
essential  to  establish  regular  habits  from  the 
beginning  of  life,  so  the  baby  should  be  awak- 
ened at  each  nursing  period.  This  is  important 
and  applies  to  the  entire  first  year  of  the  child's 
life,  except  that  after  the  first  month,  if  he 
sleeps  throughout  the  night,  it  is  not  necessary 
to  awaken  him  for  the  night  nursing.     Each 


FEEDING  87 


feeding  should  last  not  more  than  twenty 
minutes.  The  baby  should  nurse  from  one 
breast  at  one  feeding,  and  from  the  other 
breast  at  the  next  feeding,  and  care  must  be 
taken  to  see  that  the  breast  is  emptied  com- 
pletely. If  there  is  any  tendency  for  the  child 
to  go  to  sleep  during  the  feeding  period  he 
should  be  aroused  gently,  but  even  if  he  does 
not  nurse  throughout  the  entire  twenty  min- 
utes, he  should  be  removed  from  the  breast  at 
the  end  of  that  time. 

Position  of  the  Baby  While  Feeding 

While  being  fed  the  baby  should  lie  at  the 
mother's  side,  with  back  and  head  resting 
against  her  arm.  Care  must  be  taken  that 
the  head  is  free  so  that  the  mouth  may  be 
able  to  grasp  the  nipple  without  interfering 
with  breathing.  While  the  mother  is  in  bed, 
the  baby  should,  of  course,  lie  down  while 
feeding.  Later,  however,  he  may  be  held  in 
the  mother's  lap  in  a  semi-reclining  position. 

SIGNS  OF  OVER- FEEDING 

If  the  baby  is  receiving  too  much  or  too  rich 
milk,  there  is  apt  to  be  regurgitation  immedi- 
ately after  feeding.  If  vomiting  occurs,  it  is 
probably  due  to  too  much  fat  in  the  milk, 
while  wand  and  colic  probably  are  the  result 
of  too  much  solid  matter  or  protein  in  the  milk. 


88  HEALTHYBABIES 

The  baby  is  apt  to  be  restless  and  uncom- 
fortable, sleep  is  disturbed  and  attacks  of 
colic,  diarrhoea,  and  marked  constipation  are 
not  unusual.  There  usually  is  no  gain  in 
weight.  In  some  instances  the  baby  will  lose 
weight. 

Treatment 

In  both  breast  fed  and  bottle  fed  babies  the 
amount  of  food  must  be  reduced  and  the  in- 
terval between  feedings  lengthened.  Fifteen 
minutes  only  should  be  allowed  for  nursing 
at  the  breast,  while  in  the  case  of  bottle  fed 
babies  either  the  amount  should  be  reduced, 
or  a  formula  for  a  younger  baby  should  be 
substituted.  If  there  is  vomiting  due  to  too 
rich  milk,  not  only  should  the  feeding  interval 
be  lengthened,  but  the  mother  should  eat  less 
meat,  take  more  exercise,  drink  plenty  of  water 
and  the  baby  should  receive  from  one  to  two 
tablespoonfuls  of  water  after  each  feeding. 
Colic  in  a  breast  fed  baby  needs  the  same  treat- 
ment, both  as  to  improvement  in  the  mother's 
hygiene  and  lengthening  of  the  interval  be- 
tween feedings  and  giving  water  to  the  baby. 
The  mother  must  readjust  her  life  so  that  there 
will  be  no  periods  of  emotional  excitement, 
worry  or  outbursts  of  temper.  It  is  important 
that  she  should  take  an  adequate  amount  of 
exercise,    but   not   to    the   point   of   fatigue. 


FEEDING  89 


Social  activities  should  be  limited,  and  the 
diet  should  be  simple,  with  nothing  that  will 
upset  the  digestion. 

MILK  PLENTIFUL,  BUT  POOR  IN  QUALITY 

When  the  baby  is  receiving  a  sufficient 
quantity  of  milk,  but  it  is  of  such  poor  quality 
that  it  does  not  furnish  adequate  nourishment, 
the  symptoms  are  usually  manifested  by  rest- 
lessness and  constipation.  While  the  child 
seems  satisfied  immediately  after  feeding,  he 
usually  shows  symptoms  of  hunger  before  the 
next  feeding  is  due.  There  usually  is  no  gain 
in  weight.  Vomiting  or  any  other  digestive 
disturbance  rarely  occurs. 

Treatment 

The  treatment  consists  in  readjusting  the 
mother's  diet.  She  must  take  plenty  of  milk 
— at  least  three  glasses  a  day — and  should  in- 
clude cocoa,  milk  soups,  cereals  and  eggs  in 
her  diet.  She  should  have  regular  and  sys- 
tematic exercise,  and  at  least  eight  hours 
sleep  every  night,  with  one  rest  period  in  the 
middle  of  the  day. 

MILK  SCANTY,  BUT  OF  GOOD  QUALITY 

When  the  amount  of  milk  present  in  the 
breast  is  insufficient  to  last  through  a  twenty- 
minute  feeding,   the  baby  usually  manifests 


90  HEALTHYBABIBS 

some  symptoms  of  being  unsatisfied.  He  may 
be  restless  and  fretful  while  nursing,  and  be- 
tween the  nursing  periods  usually  manifests 
symptoms  of  hunger  before  the  next  feeding. 
There  is  apt  to  be  constipation,  and  the  baby 
does  not  gain  in  weight.  Sleep  may  be  dis- 
turbed. The  best  way  to  determine  whether 
the  amount  of  milk  is  scanty  is  to  weigh  the 
baby  immediately  before  and  immediately 
after  a  feeding.  He  should  have  received  an 
amount  of  milk  equal  to  one  ounce  more  than 
his  age  in  months.  If  he  does  not  show  this 
increase  in  weight  after  a  feeding,  it  is  evident 
that  the  milk  is  not  sufficient,  although  the 
quality  may  be  good. 

Treatment 

It  may  be  necessary  for  a  short  time  to  give 
the  baby  supplementary  feedings  from  the 
bottle.  This  should  not  be  given  in  place  of 
a  breast  feeding,  but  a  small  amount  of  milk, 
properly  modified  for  the  baby's  age,  may  be 
given  immediately  after  each  breast  feeding. 
The  mother  should  not  attempt  to  overfeed 
herself,  but  should  be  outdoors  as  much  as 
possible,  and  should  drink  at  least  three  glasses 
of  milk  a  day  or  the  equivalent  in  some  form 
of  soups,  cocoa,  custards,  etc.  Certain  gruels, 
especially  corn  meal  mush,  are  excellent  for 
increasing  the  supply  of  breast  milk. 


■  FEEDING  91 


Help  may  be  given  in  producing  a  sufficient 
supply  of  milk  by  seeing  that  the  breasts  are 
emptied  completely  at  each  feeding.  Some- 
times the  baby  will  stop  nursing  while  some 
milk  remains  in  the  breast.  If  this  happens 
the  breast  should  be  emptied  by  ''milking  out" 
the  remainder.  This  may  be  done  by  grasping 
the  breast  with  thumb  and  forefinger,  just 
behind  the  areola  which  surrounds  the  nipple. 
A  gentle  stroking  motion  should  then  be  used 
which  will  pull  the  nipple  and  areola  forward 
gently  with  a  movement  somewhat  similar  to 
that  which  is  used  in  milking  a  cow.  The 
pulling  must  be  slow  and  regular,  and  after  a 
little  practice  it  will  be  found  easy  to  empty 
the  breast  completely  by  this  method.  It  has 
been  found  by  numerous  studies  that  an  empty 
breast  tends  to  fill  again  rapidly  and  com- 
pletely, and  that  if  the  breast  is  emptied  at 
each  feeding  the  amount  of  milk  produced  is 
greatly  increased.  On  the  contrary,  a  breast 
that  is  only  partly  emptied  does  not  refill 
completely,  therefore  does  not  produce  the 
proper  amount  of  milk  to  nourish  the  child. 
If  the  baby  is  unable  to  empty  the  breast 
completely  the  milk  that  is  removed  from 
the  breast  by  the  method  described  may  be 
fed  to  him  from  a  medicine  dropper  or  a 
bottle. 


92  HEALTHYBABIES 

WEANING 

Weaning  should  take  place  when  the  baby 
is  from  nine  to  ten  months  old.  It  is  a  mistake 
to  prolong  breast  feeding  beyond  this  age,  as 
there  are  very  few  instances  where  the  milk 
can  fill  the  child's  needs  after  ten  months. 
Much  harm  may  come  from  too  prolonged 
nursing,  and  instances  of  failure  to  gain  in 
weight,  sleeplessness,  irritability  and  restless- 
ness may  sometimes  be  traced  to  this  cause. 
Obstinate  constipation  also  may  result  from 
too  long  continued  breast  feeding.  Exception 
to  this  rule  of  weaning  should  be  made,  how- 
ever, when  the  child  reaches  nine  or  ten  months 
of  age  during  the  summer  months.  In  such 
cases  it  is  well  to  wait  until  hot  weather  is  over 
before  weaning  is  begun. 

In  preparation  for  weaning,  it  is  a  good  idea 
to  accustom  the  child  to  the  use  of  the  bottle 
during  the  early  months  of  life.  This  may  be 
done  by  giving  water  from  the  bottle  between 
feedings.  There  are  some  instances  in  which 
it  seems  desirable  to  teach  the  baby  to  drink 
from  a  cup  as  soon  as  he  is  weaned.  This 
method  has  the  advantage  that  it  is  then  un- 
necessary to  teach  the  baby  to  give  up  the 
bottle  at  a  later  date.  The  more  ordinary 
method,  however,  is  to  substitute  the  bottle 
for  the  breast  and  then,  later,  to  accustom  the 


FEEDING  93 


child  to  the  use  of  a  cup  or  spoon.  Weaning 
from  the  bottle  should  take  place  when  the 
child  is  about  eighteen  months  of  age,  and  the 
use  of  the  bottle  should  not  be  allowed  in  any 
event  beyond  the  time  when  the  child  is  two 
years  old. 

Method  of  Weaning 

The  best  method  is  to  make  the  weaning 
gradual  by  substituting  one  bottle  feeding  for 
a  breast  feeding.  At  the  end  of  three  or  four 
days  a  second  bottle  feeding  may  be  sub- 
stituted for  another  breast  feeding.  Allowing 
the  same  interval  to  elapse  between  the  sub- 
sequent substitutions  of  additional  bottle  feed- 
ings for  breast  feedings,  the  entire  weaning 
should  take  from  two  to  three  weeks.  There 
should  be  no  haste  in  the  process,  first,  because 
it  is  necessary  for  the  baby  to  become  ac- 
customed to  the  new  method  of  feeding,  and 
second,  because  the  gradual  change  allows  the 
mother's  breast  to  dry  up  in  a  normal  manner. 

In  beginning  bottle  feedings  it  is  well  to  use 
a  milk  formula  for  a  child  two  or  three  months 
younger  than  the  baby  to  be  weaned.  As  soon 
as  the  weaning  has  been  accomplished,  the 
formula  may  be  increased  in  strength  until 
the  proper  modification  for  the  baby's  age  is 
reached.  If  too  strong  a  milk  modification  is 
used  in  the  beginning  there  is  apt  to  be  indi- 


94  HEALTHYBABIES 

gestion  with  some  colic  and  possibly  vomiting 
and  diarrhoea. 

During  the  process  of  weaning,  and  for  a 
short  time  afterwards,  there  is  usually  some 
loss  in  weight,  or  the  weight  may  remain 
stationary.  This  is  a  common  indication,  and 
no  attention  need  be  paid  to  it  unless  it  per- 
sists after  the  baby  is  taking  the  proper  milk 
formula  for  his  age.  If  loss  of  weight  then 
continues,  the  milk  modification  should  be  in- 
creased until  whole  milk  is  given.  After  that, 
other  articles  of  diet  may  be  added,  provided 
the  baby's  digestion  remains  normal. 

Care  of  the  Breasts  in  Weaning 

If  the  weaning  must  take  place  suddenly,  it 
is  possible  that  the  breasts  may  become  en- 
gorged and  painful.  If  this  occurs,  a  breast 
binder  must  be  used.  This  should  afford  as 
tight  compression  as  necessary.  Absorbent 
cotton  should  be  laid  in  folds  around  each 
breast,  with  a  small  amount  under  each  arm. 
A  strip  of  stout  muslin,  broad  enough  to  cover 
the  breasts,  and  long  enough  to  reach  well 
around  the  body,  should  then  be  drawn  tightly 
over  the  breasts,  and  pinned  or  sewed  so  as 
to  give  firm  and  even  pressure.  At  the  same 
time  the  mother  should  abstain  from  all  fluids, 
including  tea,  coffee,  milk  and  water  as  far 
as  possible,  and  each  morning  should  take  a 


FEEDING  95 


glassful  of  citrate  of  magnesia,  or  a  table- 
spoonful  of  epsom  salts  dissolved  in  a  glass  of 
water.  The  laxative  should  be  given  each  day 
in  sufficient  quantity  to  insure  three  or  four 
loose  bowel  movements.  Under  the  treat- 
ment the  milk  will  usually  leave  the  breasts 
in  the  course  of  three  or  four  days  without 
marked  disturbance  to  the  mother. 

SUBSTITUTE  FEEDING 

If  the  baby  cannot  be  nursed  from  the 
breast,  cows'  milk  properly  modified  to  suit 
the  needs  of  the  individual  infant  is  the  best 
substitute  that  can  be  provided.  In  some 
countries  and  in  certain  parts  of  the  United 
States,  the  use  of  goats'  milk  has  been  advised. 
This  is  a  good  substitute  for  human  milk,  pro- 
vided the  health  of  the  goats  is  assured.  It 
may  be  modified  in  the  same  way  as  cows'  milk. 

Composition  of  Human  Milk  and 
Cows'  Milk 

The  various  food  elements  that  are  present 
both  in  human  milk  and  cows'  milk  are  pro- 
teids,  fats,  carbohydrates,  mineral  salts  and 
water.  Proteids  are  the  solids  found  in  milk. 
Their  function  is  to  replace  the  constant  waste 
that  is  going  on  in  the  human  body,  and  also 
to  promote  the  growth  of  the  tissues  of  the 
body.    The  fats  in  the  milk  are  found  in  the 


96  HEALTHYBABIES 

cream.  They  furnish  heat  and  energy  to  the 
body,  and  also  help  replace  waste  tissue,  aid 
in  the  growth  of  the  nerve  cells  and  fibers,  and 
to  a  certain  extent,  aid  in  bone  development. 
The  excess  fats  not  used  in  body  development 
act  as  an  intestinal  laxative,  and  if  the  fats 
are  deficient  the  infant  usually  is  constipated. 
Deficient  fats  are  responsible  also  for  many 
cases  of  rickets.  Carbohydrates  are  found  in 
milk  in  the  form  of  milk  sugar.  In  the  body 
they  are  partly  converted  into  fats,  and  partly 
act  directly  in  furnishing  animal  heat.  Milk 
sugar  is  particularly  adapted  to  the  digestive 
powers  of  the  infant,  and  when  more  sugar  is 
needed  in  any  modification  of  milk  for  infant 
feeding  it  is  customary  to  use  milk  sugar  to 
supply  the  deficiency.  Cane  sugar  may  be 
used  in  place  of  milk  sugar,  but  should  be 
added  in  only  half  the  quantity  indicated  for 
milk  sugar.  An  excess  of  cane  sugar  does  harm 
in  that  it  tends  to  produce  fat,  which  makes 
the  baby  plump,  but  does  not  give  it  resisting 
power,  owing  to  the  lack  of  muscular  de- 
velopment. Mineral  Salts  are  found  both  in 
human  milk  and  in  cows'  milk  in  the  form  of 
salts  of  lime  and  magnesium.  Their  function 
is  mainly  to  build  up  the  bony  structure  of 
the  body,  and  owing  to  the  rapid  growth  of 
infants  and  children,  mineral  salts  are  more 


FEEDING  97 


important  in  their  diet  than  they  are  in  adult 
Hfe.  Water  forms  about  eighty-seven  per  cent 
of  the  composition  of  milk.  It  is  essential  as 
a  solvent  for  the  other  constituents  of  milk, 
such  as  the  proteids,  carbohydrates  and  salts, 
and  to  hold  the  fats  in  suspension  to  form  an 
emulsion.  Water  is  necessary  to  replace  the 
great  waste  of  bodily  tissue  that  is  going  on 
constantly,  and  the  fluids  that  are  lost  through 
the  bowels,  kidneys  and  skin.  In  proportion 
to  its  weight,  an  infant  requires  six  times  as 
much  water  as  an  adult  does. 

Comparison  of  Human  Milk  and 
Cows'  Milk 

The  following  table  shows  a  comparison  of 
human  milk  and  cows'  milk.** 

Human  Milk  Cows'  Milk 

Average  Per  Cent    Average  Per  Cent 

Fats 3.50  4.00 

Sugar  (carbohydrate) 7.50  4.75 

Proteids 1.25  3.50 

Salts 20  .75 

Water 87.55  87.00 

Total 100.00  100.00 

**Holt 

The  main  difference  between  human  milk 
and  cows'  milk  lies  in  the  greater  amount  of 


98  HEALTH  Y    B  A  B  lES 

sugar  in  human  milk,  and  the  excess  of  pro- 
teids  in  cows'  milk.  In  the  analysis  given 
above,  milk  with  3.5  per  cent  fat  has  been 
given  as  an  average,  as  milk  of  this  fat  content 
gives  the  best  results  in  infant  feeding.  While 
the  sugar  in  cows'  milk  is  less  than  in  human 
milk,  it  is  of  the  same  kind.  The  proteids,  oc- 
curring in  larger  amount,  also  form  a  tougher 
curd,  and  are  less  easy  of  digestion  than  the 
proteids  of  human  milk.  These  facts  all  must 
be  taken  into  account  when  deciding  how  cows' 
milk  is  to  be  modified  for  infant  feeding. 

Cows'  Milk 
Jersey,  Alderney  or  Guernsey  cows  usually 
give  milk  which  has  a  very  high  fat  content, 
therefore  its  use  is  apt  to  cause  digestive  dis- 
turbance. The  milk  from  Holstein  or  Ayrshire 
cows  is  more  desirable.  Milk  from  a  mixed 
herd  is  better  than  milk  from  a  single  cow,  be- 
cause of  the  danger  of  infection  of  the  milk 
from  one  cow.  Such  a  possibility  of  infection 
offers  less  danger  if  such  milk  is  mixed  with  the 
milk  from  a  large  number  of  cows.  The  milk 
from  a  herd  is  apt  also  to  be  more  even  in  its 
composition,  and  so  less  apt  to  produce  digest- 
ive disturbance. 

Care  of  the  Milk 
Pure  milk  may  be  defined  as  that  which  is 
obtained    from    healthy    cows,    kept    under 


FEEDING  99 


sanitary  conditions,  whose  udders  and  teats 
are  cleaned  before  milking,  the  milking  done 
with  clean  hands  directly  into  sterile  contain- 
ers, which  are  sealed  and  kept  at  a  tempera- 
ture below  50  degrees  Fahrenheit  until 
the  milk  is  used  by  the  consumer.  Such 
milk  should  not  contain  more  than  thirty 
thousand  bacteria  per  cubic  centimeter  when 
delivered  to  the  consumer.  Emphasis  must 
be  placed  upon  the  necessity  of  absolute  clean- 
liness in  milk  production  and  handling.  All 
the  cows  in  the  herd  should  be  tuberculin- 
tested  once  a  year,  so  as  to  be  sure  they  are 
free  from  tuberculosis.  If  any  cow  shows  a 
positive  reaction  to  such  a  test,  it  should  be 
removed  from  the  herd  at  once.  The  cow 
barns  should  be  kept  clean,  with  all  manure 
removed  from  the  barns  at  least  twice  a  day, 
and  stored  at  least  two  hundred  feet  distant. 
The  inside  of  the  barns  should  be  whitewashed 
at  least  twice  a  year,  and  the  floors  and  walls 
kept  in  cleanly  condition.  Before  milking, 
the  udders  and  the  teats  of  the  cows  should 
be  washed,  and  the  milker  should  wash  his  or 
her  hands  in  clean,  fresh  water,  with  soap. 
All  utensils  used  for  holding  the  milk  should 
be  washed  thoroughly  after  using,  and  scalded 
immediately  before  using.  All  persons  com- 
ing into  contact  with  the  milk  supply  should 
be  free  from  disease,  and  should  keep  their 


100  HEALTHYBABIES 

bodies  and  clothing  in  cleanly  condition.  The 
water  used  to  wash  utensils  or  to  wash  the 
hands  should  be  of  known  purity.  If  the  milk 
is  to  be  sent  any  distance,  it  should  first  be 
milked  into  clean  containers,  strained,  bottled 
and  cooled  at  the  farm.  Cooling  should  be 
carried  out  preferably  by  placing  the  bottles 
in  cold  water,  and  after  they  have  been 
thoroughly  chilled,  keeping  them  on  ice  so 
that  the  milk  will  be  at  a  temperature  of  50 
degrees  Fahrenheit  or  less,  until  it  is  delivered 
to  the  consumer. 

Care  of  Milk  to  Be  Used  Soon 
After  Milking 

When  the  milk  is  not  to  be  transported,  but 
is  to  be  used  within  a  few  hours,  it  should 
first  be  strained  through  cotton  or  thin  cheese- 
cloth into  clean  bottles  or  jars,  then  covered 
and  cooled  by  immersion  for  half  an  hour  in 
cold  water  which  reaches  to  the  neck  of  the 
bottles.  If  should  then  be  placed  in  the  ice- 
box, and  kept  very  cold  until  used. 

Types  of  Milk  Usually  on  Sale 

In  most  cities  milk  is  graded  according  to  its 
quality.  The  best  grade,  or  what  is  usually 
known  as  Grade  A,  consists  of  certified  or 
guaranteed  milk  which  is  produced  under  care- 
fully restricted  conditions,  and  is  almost  en- 


FEEDING  101 


tirely  free  from  bacteria,  or  it  may  be  milk 
which  has  been  produced  under  equally  good 
conditions,  and  then  pasteurized  before  de- 
livery. The  second  grade — Grade  B — is  bot- 
tled milk  which  is  produced  under  conditions 
a  little  less  ideal  than  for  Grade  A,  but  which 
has  been  pasteurized  before  delivery.  This 
milk  usually  sells  at  a  price  several  cents  below 
that  of  Grade  A.  It  is  not  advised  for  infant 
feeding,  but  is  perfectly  good  for  children  after 
they  have  been  weaned.  The  third  grade — 
Grade  C — is  what  is  commonly  known  as 
''grocery  milk."  Usually  it  is  sold  in  bulk, 
and  placed  in  a  container  brought  by  the  cus- 
tomer. Such  milk  is  apt  to  contain  an  enor- 
mous number  of  bacteria,  and  is  particularly 
dangerous  for  infant  feeding,  especially  during 
the  summer.  Loose  milk  should  not  be  used 
for  feeding  children  under  five  years  of  age. 

Care  of  Milk  in  the  Home 

From  the  time  the  milk  reaches  the  home 
until  it  is  used,  it  must  be  kept  cold,  clean  and 
covered.  As  soon  as  it  is  received  it  should  be 
placed  in  the  refrigerator,  close  to  the  ice,  and 
never  left  uncovered.  All  utensils  used  to 
hold  milk  should  be  absolutely  clean,  and  the 
neck  of  the  bottle  wiped  off  carefully  before 
the  milk  is  poured  out.  Before  using  the  milk 
for  infant  feeding  it  should  be  tasted  to  be 


102  HEALTHY    BABIES 

sure  it  is  fresh  and  sweet.  Thunderstorms  are 
apt  to  sour  milk  and  particular  care  must 
be  taken  that  such  milk  is  not  used  for  infant 
feeding.  Freezing  does  not  actually  change  the 
chemical  constituents  of  milk,  and  milk  that 
has  been  frozen  may  be  used  by  adults.  It  is, 
however,  most  inadvisable  to  use  it  for  infants. 
While  some  babies  do  not  react  badly  to  milk 
that  has  been  frozen,  in  some  instances  it 
causes  attacks  of  colic  and  vomiting,  and  acute 
diarrhoea,  therefore  its  use  is  to  be  avoided. 

Refrigerator 

As  so  much  depends  upon  the  care  of  the 
milk  in  the  home,  there  should  be  a  refrigerator 
kept  exclusively  for  the  baby's  use.  Where 
this  is  not  possible,  a  special  compartment  in 
the  family  refrigerator  should  be  set  aside  for 
the  baby's  milk.  This  refrigerator  or  com- 
partment should  be  scoured  at  least  once  a 
week  with  hot  soapsuds,  followed  by  a  solution 
of  washing  soda  in  water.  When  a  ready-made 
refrigerator  is  not  easily  obtainable,  one  may 
be  made  at  home  at  little  cost.  The  idea  is 
based  on  the  same  principle  as  the  fireless 
cooker,  and  the  method  of  construction  has 
been  described  by  Dr.  Alfred  Hess,  as  follows: 
"Get  a  wooden  box  at  a  grocery  store,  such 
as  a  soap  box,  fifteen  inches  in  depth.  Buy  a 
covered  earthenware  crock,  tall  enough  to  hold 


FEEDING  103 


a  quart  bottle  of  milk.  Also  get  a  piece  of 
oilcloth  or  linoleum  about  a  foot  wide  and  three 
feet  long.  Sew  the  ends  together  to  make  a 
cylinder  which  will  fit  loosely  around  the 
crock.  Place  the  crock  inside  the  oilcloth  cyl- 
inder, and  stand  them  in  the  center  of  the 
box.  Now  pack  sawdust  or  excelsior  beneath, 
and  all  about  them  to  keep  the  heat  from 
getting  in.  Complete  the  refrigerator  by  nail- 
ing a  Sunday  paper  or  two  other  newspapers 
to  the  wood  cover  of  the  box.  It  is  now 
ready  for  use. 

"In  the  morning,  as  soon  as  you  receive  the 
milk,  place  it  in  the  crock,  crack  five  cents 
worth  of  ice,  and  place  it  about  the  milk 
bottle.  Place  the  cover  on  the  crock,  and  the 
lid  on  the  wooden  box.  No  matter  how  hot 
the  day  has  been,  you  will  find  some  unmelted 
ice  in  the  crock  the  next  morning.  Remove 
the  crock  every  morning  to  pour  off  the  melted 
ice."   (See  illustration  opposite  page  67). 

If  such  a  refrigerator  is  not  available,  a 
satisfactory  substitute  may  be  improvised  by 
using  a  leaky  pail  or  a  coal  scuttle.  Place  in 
it  the  bottle  of  milk  and  a  block  of  ice,  cover 
carefully  with  a  piece  of  heavy  cloth  or  carpet, 
and  place  the  whole  in  a  sink  or  other  place 
where  it  may  drain. 


104  HEALTHYBABIES 

Thermos  Bottles 

Thermos  bottles  may  be  used  to  contain 
milk,  if  the  latter  is  thoroughly  chilled  and 
below  a  temperature  of  50  degrees  when  placed 
in  the  container.  Under  no  circumstances 
should  milk  at  a  temperature  above  50  degrees 
Fahrenheit  be  kept  in  a  thermos  bottle.  Above 
50  degrees  the  germs  in  milk  multiply  with 
great  rapidity,  and  if  the  milk  is  kept  per- 
sistently at  a  temperature  above  that  point, 
it  soon  becomes  unfit  for  human  consumption, 
and  particularly  dangerous  for  infant  feeding. 

RELATIVE  VALUE  OF  RAW  AND 
PASTEURIZED  MILK 

There  can  be  no  doubt  that  when  the  purity 
of  milk  is  assured  it  is  much  better  to  feed  the 
baby  on  raw  milk.  Recent  investigations  have 
shown  that  fresh,  raw  milk  contains  certain 
vital  elements  which  are  necessary  for  body 
growth  and  the  maintenance  of  life.  These 
elements  or  vital  principles  are  called  vitamines. 
They  exist  in  milk,  in  green  vegetables  and  in 
a  number  of  other  fresh  foods.  Prolonged 
heat  tends  to  destroy  the  vitamines.  Sterilized 
milk,  which  is  really  boiled  milk,  probably 
contains  few,  if  any,  of  these  vital  principles. 
Pasteurization  of  milk,  in  all  probability,  does 
not  destroy  the  vitamines  entirely,  but  cer- 


FEEDING  105 


tainly  it  lessens  their  efficacy.  It  is  realized, 
however,  that  there  are  few  instances  where 
purity  of  the  milk  supply  can  be  established 
definitely.  For  this  reason  some  form  of  heat- 
ing to  destroy  bacteria  or  germs  is  necessary 
in  the  vast  majority  of  instances.  While  raw 
milk,  if  of  known  purity,  is  certainly  the  best 
substitute  feeding  we  have  for  babies,  the  use 
of  sterilized  or  pasteurized  milk  may  be  made 
perfectly  safe,  provided  the  child  is  given  some 
form  of  fruit  juice  which  contains  the  vitamines 
and  which  will  make  good  the  deficiency  of 
these  vital  principles  in  the  sterilized  or  pas- 
teurized milk. 

When  sterilized  or  pasteurized  milk  is  used 
for  infant  feeding,  the  baby  should  be  given 
orange  juice  or  the  strained  juice  of  canned 
tomatoes  each  morning.  The  amount  should 
vary  from  one  teaspoonful  when  the  baby  is 
about  three  weeks  to  a  month  old,  increasing 
gradually  until  two  tablespoonfuls  are  given 
when  the  child  is  from  eight  to  nine  months  old. 

STERILIZED  MILK 

Sterilization  of  milk  consists  in  boiling  it 
for  at  least  five  minutes.  The  process  destroys 
all  germ  life  present  and,  to  a  great  extent,  it 
destroys  also  the  spores  which  are  the  early 
forms  of  germ  life  and  which  later  develop  into 
bacteria  or  germs. 


106  HEALTHYBABIES 

Result  of  Use  of  Sterilized  Milk 

Sterilization  of  milk  has  been  found  to 
render  the  curd  more  digestible.  Upon  reach- 
ing the  baby's  stomach  it  forms  into  fine 
particles  instead  of  the  heavy,  solid  curd  which 
sometimes  is  found  after  the  use  of  raw  or 
even  pasteurized  milk.  Its  advantages  are 
most  manifest  when  used  for  infants  under  two 
weeks  of  age,  and  in  its  use  throughout  hot 
weather.  Boiled  or  sterilized  milk  should  al- 
ways be  used  if  there  is  doubt  as  to  the  clean- 
liness of  the  milk  supply.  The  disadvantages 
are  that  its  prolonged  use  is  apt  to  cause  con- 
stipation. This  may  be  corrected,  however,  by 
adding  more  sugar  to  the  milk  formula  or  by 
substituting  cane  sugar  for  milk  sugar.  An- 
other disadvantage  is  that  sterilized  milk,  be- 
cause of  its  lack  of  vitamines,  may  result  in 
scurvy.  This  may  be  avoided  by  the  use  of 
orange  juice  or  the  strained  juice  of  canned 
tomatoes  in  the  amounts,  and  in  the  manner 
described  in  the  paragraph  on  ''Relative  Value 
of  Raw  and  Pasteurized  Milk.'' 

PASTEURIZED  MILK 

Pasteurization  consists  in  heating  milk  to  a 
temperature  of  145  degrees  Fahrenheit,  and 
keeping  it  at  that  temperature  for  thirty 
minutes.    This  process  destroys  practically  all 


FEEDING  107 


bacteria  but  does  not  destroy  all  the  spores, 
therefore,  if  pasteurized  milk  is  not  kept  at  a 
temperature  below  50  degrees,  it  soon  will 
contain  as  many  bacteria  as  it  contained  orig- 
inally, although  they  will  be  of  a  different  kind. 
The  main  bacteria  in  milk  are  those  which 
convert  the  milk  sugar  into  acid  and  cause 
souring.  These  bacteria  are  destroyed  by 
pasteurization,  as  are  also  the  bacteria  of  any 
specific  disease  such  as  scarlet  fever,  diph- 
theria or  tuberculosis,  if  through  any  mis- 
chance the  milk  should  have  become  infected 
by  such  germs.  While  these  bacteria  are 
destroyed  by  pasteurization,  a  certain  type 
of  bacteria  which  are  called  the  ''protein- 
attacking  bacilli"  are  left  unharmed,  therefore, 
although  pasteurized  milk  does  not  sour  easily, 
the  proteins  in  it  become  decomposed  and  in 
time  the  milk  becomes  spoiled  and  easily 
causes  digestive  disturbance  in  infants.  It 
must  be  remembered,  also,  that  pasteurized 
milk  is  just  as  likely  to  become  reinfected  as 
raw  milk,  and  therefore,  it  must  be  kept  as 
clean  and  as  cold  as  raw  milk,  and  particular 
attention  must  be  paid  to  seeing  that  it  is 
kept  covered  so  that  there  may  be  no  danger 
of  its  reinfection.  Notwithstanding  these  dis- 
advantages, the  use  of  pasteurized  milk  is 
advised  in  every  instance  where  there  is  any 
doubt  whatever  as  to  the  purity  of  the  milk 


108  HEALTHYBABIES 

supply.  Pasteurized  milk  does  not  have  the 
disadvantages  of  sterilized  milk,  while  pos- 
sessing practically  all  its  advantages. 

Methods  of  Home  Pasteurization 

If  there  is  any  doubt  as  to  the  purity  of  the 
milk  supply,  and  if  pasteurized  milk  cannot  be 
obtained,  home  pasteurization  is  a  simple 
matter  and  readily  carried  out.  There  are  a 
large  number  of  pasteurizers  on  the  market. 
They  consist  usually  of  a  round  pail  with  a 
wire  rack  to  hold  the  bottles.  The  individual 
feeding  bottles  are  placed  in  the  rack,  which 
is  let  down  into  the  pail  of  water.  The  whole 
is  then  placed  on  the  stove  and  the  ther- 
mometer which  is  part  of  the  pasteurizer,  will 
indicate  when  a  temperature  of  145  degrees 
has  been  reached.  The  water  is  kept  at  this 
temperature  by  keeping  the  heat  even  for  a 
period  of  thirty  minutes.  The  bottles  then  are 
removed  from  the  pasteurizer,  cooled  rapidly 
by  being  placed  in  cold  water  or  under  cool 
running  water,  and  as  soon  as  they  are  cold, 
they  are  to  be  placed  in  the  icebox,  to  be  kept 
until  needed.  A  simple  form  of  home  pas- 
teurizer may  be  made  as  follows:  Take  a  pail 
deep  enough  to  allow  the  water  to  reach  to 
the  neck  of  a  quart  milk  bottle.  Place  an  in- 
verted saucer  in  the  bottom  of  the  pail,  and 
set  the  bottle  of  milk  on  this.    Pour  in  water 


FEEDING  109 


up  to  the  top  level  of  the  milk.  Place  the 
whole  on  the  stove  and  let  the  water  come  to 
a  boil.  As  soon  as  it  begins  to  boil,  remove 
the  pail  from  the  fire,  cover  and  let  it  stand 
for  half  an  hour.  Then  remove  the  milk  bottle 
and  cool  it  quickly  by  letting  cold  water 
run  over  it  or  by  placing  it  in  cold  water. 
The  bottles  then  should  be  placed  on  the 
ice  and  kept  cold. 

MODIFICATION  OF  MILK 

Cows'  milk,  because  it  is  suited  to  the 
stomach  of  a  calf  and  not  to  the  stomach  of  a 
human  baby,  needs  to  be  modified  before  it 
is  used  for  infant  feeding.  This  modification 
is  intended  to  make  it  as  nearly  as  possible 
like  human  milk,  which  is  provided  to  suit 
the  different  ages  of  the  child.  The  process  of 
modification  consists,  first  in  diluting  the  milk 
with  water  to  reduce  the  proportion  of  proteins 
found  in  cows'  milk.  This  dilution,  however, 
reduces  the  other  constituents  of  the  milk,  so 
that  it  is  essential  to  add  other  ingredients  to 
bring  the  whole  mixture  back  to  the  desired 
point.  Next,  milk  sugar  is  added,  to  supply 
the  deficiency  of  sugar  caused  by  the  dilution. 
Third,  it  may  be  necessary,  in  certain  in- 
stances, to  add  cream  or  lime  water  to  increase 
the  amount  of  fats  or  to  add  to  the  mineral 


110  HEALTHYBABIES 

salts  in  the  cows'  milk.    This  should  never  be 
done,  however,  without  a  physician's  advice. 

Principles  of  Milk  Modifications 

There  is  probably  no  one  subject  with  re- 
lation to  the  care  of  babies  about  which  more 
has  been  written  than  the  proper  way  to 
modify  cows'  milk  for  infant  feeding.  In  the 
past,  various  methods  have  been  tried  out  and 
the  most  intricate  kinds  of  formulae  have  been 
advised  and  used.  Experience  has  shown, 
however,  that  there  is  no  need  for  intricate 
modifications  for  proper  baby  feeding.  In- 
deed, many  of  the  most  carefully  thought  out 
formulae  do  not  agree  at  all  with  the  digestive 
powers  of  the  infant.  The  day  is  past  when 
the  mother  needs  to  burden  her  mind  with 
perplexing  percentage  formulae  and  top  milk 
mixtures.  The  simplest  methods  of  baby 
feeding  are  the  best.  Ordinary  dilutions  of 
milk,  with  the  addition  of  a  little  milk  sugar 
or  cane  sugar,  are  all  that  are  necessary  for 
the  best  results  in  baby  feeding.  The  formulae 
given  in  this  book,  therefore,  are  based  upon 
this  principle.  It  must  be  remembered,  how- 
ever, that  no  definite  and  absolute  set  of 
formulae  can  be  given  to  suit  all  infants.  Un- 
fortunately, the  feeding  of  babies  is  not  quite 
so  simple  as  that,  but  there  are  certain 
principles  which  are  so  well  established  that 


FEEDING  111 

it  is  possible  now  to  give  a  general  outline  of 
feeding  which  is  suited  to  the  average  baby 
of  a  given  weight  and  age.  This  does  not 
mean  that  this  formula  always  will  agree  with 
every  baby  of  that  weight  and  age,  but  in  the 
few  instances  where  it  does  not,  the  various 
methods  described  in  this  book  may  be  used 
to  alter  the  modification  to  make  it  suit  the 
infant  in  question.     (See  table  on  page  112). 

Method  of  Choosing  the  Proper  Formula 

The  formula  should  be  chosen  by  the  weight 
of  the  child  rather  than  by  his  age.  If,  how- 
ever, the  baby  weighs  eight  or  nine  pounds  at 
birth,  it  is  not  wise  to  begin  with  the  formula 
for  an  eight  or  nine  pound  baby.  For  the  first 
four  weeks  of  life  the  formula  chosen  should 
be  that  which  relates  to  the  age  of  the  baby 
rather  than  his  weight,  but  after  that  time  the 
weight  is  the  point  to  be  considered. 

Amount  to  Be  Given  at  Each  Feeding 

In  general,  the  baby  should  take  at  each 
feeding  one  to  one  and  a  half  ounces  more  than 
he  is  months  old,  up  to  the  seventh  month. 
After  that  he  should  take  an  amount  equal  to 
his  age  in  months,  until  eight  ounces  have  been 
reached.  The  amount  need  not  be  increased 
after  that  age.  For  example,  a  baby  two 
months  old  should  take  from  three  to  three 


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FEEDING  113 


and  a  half  ounces  of  the  mixture,  at  three 
months,  four  ounces,  while  a  baby  seven 
months  will  take  eight  ounces  of  milk,  a  baby 
eight  months  will  take  eight  ounces,  and  a 
baby  nine  months  will  take  the  same  amount. 
These  amounts  equal  the  capacity  of  the 
child's  stomach  at  the  ages  given.  A  greater 
amount  of  food  tends  to  dilate  the  stomach 
and  cause  symptoms  of  overfeeding. 

Intervals  of  Feeding 

From  birth  the  baby  should  be  fed  at  in- 
tervals of  not  less  than  three  hours,  with  one 
night  feeding.  When  he  is  three  months  old 
the  night  feeding  should  be  omitted.  At  six 
months  the  interval  of  feeding  should  be 
lengthened  to  four  hours.  With  robust  infants 
the  four-hour  interval  may  be  used  from  the 
beginning.  Whenever  it  is  possible  to  omit 
the  night  feeding  at  an  earlier  age  than  that 
given,  that  plan  should  be  carried  out.  Fre- 
quently, babies  can  be  made  to  sleep  all  night 
from  the  time  they  are  born.  They  should 
never  be  awakened  at  night  for  a  feeding,  and 
the  night  feeding  should  be  omitted  as  early 
in  life  as  possible.  In  any  event,  it  should 
never  be  continued  after  the  third  month. 

The  interval  of  feeding  and  the  amounts  at 
each  feeding  recommended  in  the  table  have 
been  found  to  lessen  the  liability  to  digestive 


114  HEALTHY    BABIES 


disturbance,  to  prevent  regurgitation,  vomit- 
ing, diarrhoea,  colic  and  wind.  Babies  fed  at 
these  intervals  are  most  restful,  better  nour- 
ished and  have  a  finer  development.  Many  of 
the  digestive  disturbances  of  the  past  may 
be  traced  directly  to  the  practice  of  feeding 
babies  too  frequently  and  in  too  large  amounts. 
Not  only  is  the  capacity  of  the  baby's  stomach 
limited,  but  investigations  have  shown  that 
it  takes  from  two  and  a  half  to  three  hours  for 
a  baby  to  digest  milk.  To  give  him  additional 
milk  before  the  amount  already  in  his  stom- 
ach has  been  digested  is  one  of  the  easiest 
ways  of  promoting  digestive  disturbance  and 
causing  illness. 

Use  of  Water  in  Infant  Feeding 

Every  baby  needs  water  to  drink.  When 
the  three  or  four-hour  feeding  schedule  is 
used,  water  should  never  be  omitted.  During 
the  first  week  at  least  two  teaspoonfuls  should 
be  given  between  feedings,  and  this  amount 
should  be  increased  gradually  until  the  baby 
at  six  months  is  getting  from  two  to  four  table- 
spoonfuls  between  feedings.  Water  should  be 
given  from  a  nursing  bottle  or  from  a  spoon. 

Utensils  Needed  for  Modifying  Milk 

The  following  utensils  are  needed  for  modifying  milk: 
(See  illustrations  on  pages  114  and  115.) 


FEEDING  115 


Eight  four-ounce  bottles.  For  the  later  months,  eight-ounce 
bottles  are  necessary.  They  should  have  wide  mouths  so 
that  they  may  be  cleaned  easily. 

Nipples — Rubber  of  good  quality  is  advised.  They  should 
have  no  holes  when  purchased.  Holes  of  proper  size  may 
be  made  with  a  No.  10  Cambric  needle  which  has  been 
heated  and  then  plunged  into  the  rubber.  The  hole  should 
be  of  a  size  which  will  permit  the  milk  to  flow  drop  by  drop 
when  the  bottle  is  held  upside  down.  Any  steady  flow  of 
milk  shows  that  the  nipple  hole  is  too  large.  If  the  baby 
finishes  contents  of  the  bottle  in  less  than  twenty  minutes, 
this  also  is  an  indication  that  the  hole  in  the  nipple  is  too 
large. 

Brush  for  cleaning  bottles  and  nipples. 

Two-quart  pitcher. 

Eight-ounce  or  sixteen-ounce  glass  graduate,  for  measuring. 

Double  boiler. 

Saucepan. 

Strainer. 

Funnel  for  filling  bottles. 

Dishpan  for  sterilizing  bottles. 

Bottle  rack. 

Teaspoon  and  tablespoon. 

Jar  for  holding  nipples. 

Package  of  non-absorbent  cotton. 

Method  of  Preparing  Modified  Milk 

All  milk  to  be  used  for  the  day  should  be 
prepared  each  morning.  A  clean  table  should 
be  available  to  work  on.  All  utensils  should  be 
scalded  in  hot  water,  and  the  outside  of  the 
milk  bottle  washed  with  cold  water  before  the 
cap  is  removed.  If  barley  water,  rice  water 
or  oatmeal  water  is  to  be  used,  it  should  be 


116  HEALTHY    BABIES 

prepared  first.  The  cereal  should  be  measured 
accurately  and  creamed  in  cold  water  to  avoid 
lumps.  It  should  then  be  added  to  the  water 
in  the  double  boiler,  stirred  constantly  to 
avoid  scorching,  and  boiled  for  thirty  minutes. 
After  the  barley  water  has  been  prepared,  the 
sugar  needed  for  the  day's  feeding  should  be 
measured  out  and  dissolved  in  a  few  table- 
spoonfuls  of  boiled  water.  This  should  be 
placed  in  the  pitcher,  the  necessary  amount 
of  milk  added,  then  the  water  or  barley  water, 
the  whole  stirred  well  together  and  the  bottles 
filled,  using  the  funnel.  After  filling,  the  top 
of  each  bottle  should  be  plugged  with  a  small 
piece  of  the  non-absorbent  cotton  and  all 
placed  on  the  ice  to  be  kept  until  needed. 

Feeding  the  Baby 

At  the  time  of  feeding,  the  bottle  should  be 
removed  from  the  icebox  and  placed  in  a  jar 
of  warm  water.  The  milk  should  be  at  body 
heat  when  used.  This  may  be  ascertained  by 
letting  a  few  drops  fall  on  the  wrist.  The  nipple 
should  never  be  put  in  the  mouth  to  test  the 
temperature  or  the  taste  of  the  milk.  A  little 
of  the  milk  mixture  may  be  poured  into  a 
spoon  and  tasted  to  be  sure  it  is  sweet  before 
it  is  given  to  the  baby.  As  soon  as  the  milk 
is  at  blood  heat  or  body  temperature,  a  clean 
nipple  should  be  placed  on  the  bottle,  and  the 


FEEDING  117 


feeding  given  to  the  baby  at  once.  Any  milk 
that  may  be  left  in  the  bottle  after  feeding 
must  be  thrown  away. 

Care  of  the  Bottles 

Immediately  after  using,  the  bottle  should 
be  rinsed  with  cold  water,  then  washed  with 
hot  water  and  placed  upside  down  In  the 
bottle  rack  until  needed  for  filling  on  the  fol- 
lowing morning.  Before  the  bottles  are  filled 
again  they  should  be  scalded  with  hot  water. 

Care  of  the  Nipples 

As  soon  as  they  have  been  used,  the  nipples 
should  be  rinsed  out  with  cold  water  and 
turned  inside  out  so  that  no  particles  of  milk 
may  adhere  to  the  inner  surface.  They  should 
then  be  scrubbed  thoroughly  in  warm  soap- 
suds and  water.  It  is  not  necessary  to  boil 
the  nipples  every  day,  although  this  should  be 
done  once  a  week.  Rubber  spoils  rapidly  and 
if  ordinary  precautions  of  cleanliness  are  ob- 
served this  extreme  heating  at  frequent  in- 
tervals is  not  essential.  In  the  intervals  be- 
tween using,  the  nipples  should  be  kept  in  a 
covered  jar  filled  with  a  solution  of  borax, 
one  teaspoonful  to  a  glass  of  water,  or  table 
salt,  one  teaspoonful  to  a  glass  of  water.  Be- 
fore using,  they  should  be  rinsed  with  warm 
water. 


118  HEALTHY    BABIES 

When  Amount  of  Food  or  Strength  of  Formula 
Should  Be  Increased  or  Decreased    ■ 

The  amount  or  strength  of  the  formula  may- 
be increased  if  the  baby's  digestive  condition 
is  good,  that  is,  if  there  is  no  vomiting  or 
diarrhoea,  but  if  the  child  seems  to  be  hungry 
after  feeding,  shows  evidence  of  not  being 
satisfied,  and  the  weight  either  remains  sta- 
tionary or  decreases.  There  should  be  only 
the  regular  increase  in  the  quantity  and 
strength  of  the  food  if  the  child  is  gaining 
regularly,  seems  comfortable  and  sleeps  well. 
The  strength  and  quantity  of  the  food  should 
be  decreased,  that  is,  more  water  should  be 
added  or  the  formula  for  a  younger  child  used, 
if  the  child  shows  a  tendency  to  diarrhoea, 
vomiting,  marked  restlessness  or  evidence  of 
over-feeding,  such  as  regurgitation,  colic,  wind 
or  other  evidence  of  indigestion. 

Use  of  Other  Ingredients  in  Milk 
Modification 

If  the  child  is  not  gaining  in  weight,  but 
there  is  no  digestive  disturbance  such  as 
vomiting  or  diarrhoea,  or  if  marked  constipa- 
tion is  present,  milk  sugar  or  cane  sugar  may 
be  left  out  of  the  formula  and  replaced  by  malt 
sugar  (Mead's  Dextri- Maltose)  or  one  of  the 
cereal  proprietary  foods  such  as  Horlick's  or 


FEEDING  119 


Borden's  malted  milk  or  Mellen's  food,  in  the 
quantity  of  two  level  tablespoonfuLs  to  each 
twenty  ounces  of  the  milk  mixture.  There 
are  also  two  liquid  forms  of  malt  sugar,  known 
as  "malt  zymose"  and  ''Loeflund's  malt  soup." 
When  using  these,  the  day's  feedings  should 
be  prepared  without  sugar  and  two  table- 
spoonfuls  of  either  of  the  liquids  mentioned 
should  be  added  to  the  milk  and  barley  water, 
and  the  whole  brought  to  a  boil.  This  should 
then  be  placed  in  the  individual  feeding  bottles 
and  cooled  in  the  usual  way.  The  amount 
of  Loeflund's  malt  soup  or  malt  zymose  may 
be  increased  by  one  teaspoonful  every  day 
until  there  is  some  indication  that  the  stools 
are  loose,  when  the  amount  may  be  reduced 
by  two  or  three  teaspoonfuls  at  a  time  un- 
til the  stools  are  normal  in  consistency  and 
number  of  movements.  The  use  of  the  pre- 
paration described  above  causes  the  stools  to 
be  of  a  brownish  color.  When  indigestion  is 
manifested  by  vomiting,  colic  or  diarrhoea, 
skimmed  milk  should  be  substituted  for  the 
whole  milk  in  the  modification,  and  the 
greater  part  of  any  kind  of  sugar  omitted. 
The  malt  sugar  and  foods  mentioned  above 
should  never  be  used  if  there  is  vomiting  or 


diarrhoea. 


120  HEALTHYBABIES 


DRIED  MILK 

Milk  from  which  practically  all  of  the  water 
has  been  removed,  leaving  only  the  solid 
parts,  has  been  put  upon  the  market  within 
the  last  few  years  under  various  trade  names. 
Practically  all  of  the  brands  are  reliable. 
Some  preparations  consist  of  the  solids  of 
whole  milk,  including  the  cream;  others  have 
had  the  cream  removed  from  the  milk  before 
the  water  has  been  evaporated. 

The  usual  process  of  preparing  this  milk  is 
by  spraying  it  upon  hot  revolving  cylinders 
v/hich  drive  out  all  of  the  water  at  once.  The 
powdered  or  dried  milk  is  then  placed  in 
sterile  containers  and  sealed.  Powdered  skim- 
med milk  will  keep  almost  indefinitely.  The 
powdered  whole  milk  will  keep  for  several 
months  but  may  become  rancid. 

In  order  to  use  this  milk  for  infant  feeding 
it  is  usual  to  add  one  part  of  the  milk  powder 
to  eight  parts  of  water,  in  order  to  bring  it 
back  to  the  full  strength  of  the  ordinary  fluid 
milk.  It  may  then  be  modified  in  accordance 
with  the  directions  given  for  fluid  milk. 

Dried  milk  has  many  advantages.  It  is 
uniform  in  its  composition,  sterile,  easily  car- 
ried from  place  to  place  and  does  not  require 
ice  to  keep  it  in  hot  weather.  It  may  be  con- 
sidered   an   excellent  substitute  for  fluid  milk 


FEEDING  121 


when  the  latter  is  not  available  or  if  the  purity 
of  the  milk  supply  is  questioned. 

CONDENSED  MILK  AND  PROPRIETARY  FOODS 

Condensed  Milk 

Condensed  milk  is  prepared  by  bringing 
whole  milk  to  a  very  high  temperature  in  a 
vacuum,  then  adding  sufficient  sugar  so  that 
it  will  keep  for  a  considerable  period  of  time. 
Canned  condensed  milk  will  keep  almost  in- 
definitely. 

Evaporated  Milk 

Evaporated  milk  is  prepared  in  the  same 
manner  as  condensed  milk,  except  that  the 
sugar  is  not  added.  The  process  of  condensing 
or  evaporating  milk  extracts  some  of  the  water, 
leaving  the  solids  in  the  form  of  a  thin  paste. 

Use  of  Condensed  Milk  in  Infant  Feeding 

Where  the  purity  of  the  milk  supply  cannot 
be  assured  and  where  it  is  difficult  if  not  im- 
possible to  sterilize  or  pasteurize  it,  as  in 
traveling  or  in  the  case  of  temporary  residence 
in  various  places,  also  when  a  child  is  suffering 
from  a  form  of  indigestion  which  causes  colic 
and  wind,  condensed  milk  may  be  used  for  a 
time.  Its  prolonged  use,  however,  is  not  ad- 
vised as  the  amount  of  sugar  in  condensed 
mi  k  is  apt  to  increase  the  child's  weight  by 


122  HEALTHYBABIES 

increasing  the  fat  deposit  in  the  body,  while 
the  muscular  strength  is  not  increased.  Babies 
fed  habitually  on  condensed  milk  are  less  apt 
to  be  resistant  to  disease  than  those  fed  on 
fresh,  pasteurized  or  sterilized  milk. 

How  to  Prepare  Condensed  Milk  for 
Infant  Feeding 

For  a  child  three  months  old,  one  part  of 
condensed  milk  to  fifteen  parts  of  water 
furnishes  a  good  proportion.  This  may  be 
prepared  by  pouring  one  teaspoonful  of  con- 
densed milk  from  the  can  and  adding  to  it 
four  ounces  of  water.  The  strength  of  this 
mixture  may  be  increased  gradually  until  the 
child  at  six  months  of  age  is  taking  a  mixture 
in  the  proportion  of  a  teaspoonful  of  the  milk 
to  two  ounces  of  water.  In  preparing  con- 
densed milk  it  must  be  remembered  that  the 
spoon  should  not  be  placed  in  the  can,  and  the 
milk  dipped  out.  The  required  amount  should 
be  poured  from  the  can  into  a  clean  spoon  and 
measured  in  that  way. 

Use  of  Evaporated  Milk 

Evaporated  milk  may  be  used  in  the  same 
way  and  in  the  same  proportion  as  condensed 
milk.  As  there  is  no  sugar  in  the  milk,  some 
may  be  added  in  the  proportion  of  one  tea- 
spoonful of  milk  sugar  to  every  six  ounces  of 


-# 


FEEDING  123 


the  mixture.  As  evaporated  milk  will  not 
keep  it  must  be  used  within  twenty-four  hours 
of  the  time  the  can  is  opened. 

Proprietary  Foods 

Practically  all  the  proprietary  foods  depend 
upon  their  cereal  content.  Certain  of  them 
have  starch  as  an  ingredient.  Very  young 
babies  do  not  digest  starch  readily,  therefore, 
in  general,  the  proprietary  foods  should  not 
be  given  to  children  until  they  are  over  three 
months  of  age.  If  the  baby  is  not  thriving  on 
cows'  milk  mixture,  and  particularly  if  there 
is  any  indigestion  with  marked  constipation, 
one  of  the  cereal  foods,  such  as  Mellen's  or 
Horlick's,  may  be  added  to  the  milk.  These 
foods  may  be  used  also  in  place  of  the  milk 
sugar  or  cane  sugar  in  modifying  cows'  milk, 
particularly  if  there  is  any  tendency  to  colic, 
wind  or  constipation  in  the  infant.  For  babies 
over  three  months  of  age,  various  other  infant 
foods  such  as  Imperial  Granum,  Nestle's  or 
Eskay's  may  also  be  used.  It  must  be  under- 
stood, however,  that  any  of  these  prepared  in- 
fant foods,  unless  they  are  made  up  with  cows' 
milk,  do  not  furnish  in  the  right  proportion 
the  necessary  constituents  to  keep  the  baby 
in  good  health.  There  are  cases  where  the 
ordinary  modifications  of  cows'  milk  do  not 
seem  to  suit  the  infant's  digestion.     In  such 


124  HEALTHY    BABIES 

instances  it  may  be  necessary  to  try  not  only 
one,  but  many  of  the  various  types  of  pro- 
prietary foods,  but  just  so  far  as  possible  they 
must  be  made  up  with  cows'  milk.  Plain,  fresh, 
pasteurized  or  sterilized  cows'  milk,  properly 
modified  with  water,  barley  water  and  milk 
sugar  is  the  best  substitute  we  have  for  breast 
feeding.  However,  if  its  use  is  not  tolerated 
by  the  baby  after  repeated  attempts  to  select 
a  satisfactory  formula,  it  will  probably  be 
necessary  to  try  out  the  condensed  or  evapor- 
ated milk  until  the  infant's  digestion  is  in  good 
condition,  and  then  begin  with  one  of  the 
proprietary  foods.  No  special  one  can  be 
recommended  above  the  others.  All  that 
have  been  mentioned  are  standard  and  reliable, 
and  with  the  reservation  given  as  to  the  age 
at  which  the  child  can  take  the  special  kinds 
of  food,  any  one  of  them  may  be  selected. 

ADDITIONAL  FEEDING  UNDER  ONE  YEAR 

Three  to  Four  Months 

Barley  water  should  be  substituted  for  plain 
water  in  milk  modifications.  If  there  is  a  tend- 
ency for  the  baby  to  be  constipated,  oatmeal 
water  may  be  used  in  place  of  the  barley  water. 

Two  to  Six  Months 

Orange  juice  or  the  strained  juice  of  canned 
tomatoes  should  be  given  to  babies  as  early 


FEEDING  125 


as  two  months,  if  pasteurized  or  sterilized  milk 
is  used.  Breast  fed  babies  need  not  have  the 
orange  juice  until  they  are  about  six  months 
old.  It  should  be  given  in  two  teaspoonful 
amounts  to  start  with,  and  gradually  increased 
until  at  six  months  the  baby  is  receiving  at 
least  a  tablespoonful,  and  at  nine  months  two 
tablespoonfuls.  The  juice  of  canned  tomatoes 
may  be  substituted  for  the  orange  juice  in  any 
instance,  and  is  equally  as  effective  as  orange 
juice  in  preventing  scurvy  in  infants  who  are 
fed  on  pasteurized  or  sterilized  milk. 

Six  to  Nine  Months 

In  bottle  fed  babies,  beef,  lamb  or  chicken 
broth  may  be  given  for  one  feeding  of  the  day 
as  early  as  six  months.  If  the  baby  is  doing 
well  on  the  milk  mixture,  it  is  not  advisable 
to  change  the  diet,  but  if  there  are  indications 
that  the  milk  is  not  all  that  is  necessary  and 
the  baby  seems  hungry  and  restless,  one  ounce 
(two  tablespoonfuls)  of  the  broth  may  be 
given  once  a  day. 

Six  Months 

If  the  baby  is  delicate  it  is  advisable  to 
begin  with  beef  juice,  one  teaspoonful  every 
other  day  for  children  as  young  as  six  months. 
All  babies  at  nine  months  should  have  beef 
juice  on  alternate  days.     It  can  be  given  on  a 


126  HEALTHYBABIES 

little  dry  bread.  Beginning  with  one  tea- 
spoonful,  it  may  be  increased  gradually  until 
at  one  year  the  child  is  receiving  from  two  to 
four  teaspoonfuls  on  dry  bread  at  a  meal. 
The  white  of  a  coddled  egg  also  may  be  given 
as  early  as  six  months,  but  should  never  be 
given  on  the  same  day  as  beef  juice. 

Eight  to  Ten  Months 

When  the  teeth  come  through  on  both  upper 
and  lower  jaws,  the  baby  should  have  a  small 
piece  of  zwieback,  once  a  day  or  a  hard  Hunt- 
ley &  Palmer  biscuit  to  chew  on. 

Nine  to  Ten  Months 

At  this  time,  the  baby,  having  been  weaned, 
may  have  a  teaspoonful  of  the  mealy  part  of 
a  baked  or  boiled  potato  with  a  little  dish 
gravy  or  beef  juice,  a  teaspoonful  of  scraped 
beef  or  two  ounces  of  milk,  vegetable  or  spin- 
ach soup.  Soup,  broth,  beef  juice  or  coddled 
egg  should  not  be  given  on  the  same  day. 
At  this  time,  however,  cereal  gruels  may  be 
given  once  daily. 

When  the  child  begins  to  take  solid  food, 
not  more  than  a  quart  of  milk  a  day  need  be 
given.  Part  of  this  may  be  in  the  form  of 
junket. 


CHAPTER  VII 

STOMACH  AND  BOWEL  DISORDERS 

LOSS  OF  APPETITE 

In  babies  under  one  year  of  age  loss  of 
appetite  usually  is  shown  by  refusal  to  take 
the  bottle  or  breast  feeding  at  the  regular 
time.  The  cause  is  almost  entirely  due  to  some 
error  in  feeding;  that  is,  the  food  is  given  at 
too  frequent  intervals,  the  milk  mixture  is 
too  rich  (there  is  too  much  cream  in  it)  or,  in 
older  babies,  loss  of  appetite  may  be  due  to  the 
fact  that  the  milk  feedings  have  been  con- 
tinued for  too  long  a  time  and  other  articles 
of  food  are  desirable.  Other  causes  are  chronic 
constipation,  hot  weather,  lack  of  fresh  air 
indoors  and  too  little  airing  out-of-doors.  Loss 
of  appetite  is  apparent,  also  at  the  beginning 
of  any  acute  illness. 

Treatment 

The  method  of  dealing  with  loss  of  appetite 
is  obvious.  The  interval  between  feedings 
should  be  lengthened,  and  generally,  the 
strength  of  the  milk  mixture  should  be  reduced. 
This  is  particularly  necessary  in  hot  weather, 
when  water  should  be  added  to  the  feeding, 
and  in  addition  the  baby  should  receive  plenty 
of  water  to  drink  between  feedings.  Lengthen- 
ing the  feeding  interval  also  is  of  the  utmost 

127 


128  HE  ALTHY    B  ABIES 


importance  in  hot  weather,  and  no  attempt 
should  be  made  to  increase  the  strength  of  the 
formula  during  the  heated  term.  Attention 
must  be  paid  to  the  condition  of  the  bowels, 
and  if  constipation  exists  effort  must  be  made 
to  overcome  it.  The  baby  must  be  kept  in 
the  fresh  air  as  much  as  possible,  and  the 
sleeping  room  must  be  well  ventilated  at  night. 
If  the  loss  of  appetite  is  due  to  the  onset  of 
severe  illness,  other  symptoms  such  as  fever, 
irritability,  restlessness,  with  possible  vomit- 
ing and  diarrhoea,  will  manifest  themselves 
within  a  few  hours  and  attention  must  be  paid 
to  the  illness  rather  than  to  the  symptom  of 
loss  of  appetite. 

REGURGITATION 

Nearly  all  babies  who  have  been  overfed 
"overflow"  or  regurgitate  their  food  immedi- 
ately after  feeding.  Sometimes  this  condition 
occurs  when  only  a  normal  amount  of  food  has 
been  taken. 

Treatment 

In  such  instances  attention  must  be  paid  to 
the  condition  of  the  clothing  as  this  type  of 
regurgitation  occurs  frequently  as  a  result  of 
an  abdominal  binder  or  a  diaper  which  is 
fastened  too  tightly  around  the  child's  waist. 
For  the  type  of  regurgitation  which  is  caused 


STOMACH    AND    BOWEL    DISORDERS        129 

by  overfeeding,  the  remedy  is  to  lengthen  the 
interval  of  feeding,  and  if  this  does  not  bring 
about  the  desired  result,  water  should  be 
added  after  the  breast  feeding  or  the  bottle 
formula  should  be  diluted  with  water.  If 
regurgitation  occurs  immediately  after  feeding, 
the  child  should  be  placed  quietly  in  his  crib 
and  not  handled. 

VOMITING 

If  the  vomiting  occurs  soon  after  feeding,  it 
is  probable  that  the  child  is  receiving  too 
large  a  quantity  of  milk,  or  that  the  hole  in 
the  nipple  may  be  too  large,  and  the  food  is 
swallowed  too  rapidly.  Handling  the  baby 
immediately  after  feeding,  feeding  him  at  too 
frequent  intervals,  or  tight  clothing  which  con- 
stricts the  abdomen  are  all  causes  of  vomiting. 

Treatment 

The  treatment  consists  in  removing  the 
cause.  The  quantity  of  milk  may  be  reduced, 
the  period  of  feeding  should  be  shortened  to 
fifteen  minutes,  care  must  be  taken  to  see  that 
the  baby  does  not  nurse  too  rapidly,  the 
clothing  should  be  readjusted  and  the  interval 
between  feedings  lengthened.  The  baby  should, 
of  course,  be  placed  quietly  in  his  crib  im- 
mediately after  feeding,  although  in  case  any 
gas  or  wind  is  present,  he  may  be  held  up  over 


130  HEALTHY    BABIES 

the  mother's  shoulders  and  his  back  patted 
gently  in  order  to  stimulate  the  eructation  of 
the  gas. 

Vomiting  some  time  after  feeding  usually  is 
due  to  some  change  in  the  quality  of  the  milk. 
It  may  be  that  there  is  too  much  fat,  too  much 
sugar,  that  the  milk  is  stale  or  that  the  milk 
modification  is  too  strong. 

Treatment 

In  the  case  of  the  breast  fed  baby,  the  treat- 
ment is  to  lengthen  the  interval  between  feed- 
ings, and  to  give  a  smaller  quantity  of  food. 
If  the  vomiting  is  persistent  the  baby  may  be 
fed  wholly  on  barley  water  for  three  or  four 
feedings,  and  returned  to  the  breast  for  five 
or  ten  minutes  for  the  next  three  or  four 
feedings.  Water  should  be  given  freely  be- 
tween feedings  and  the  feeding  interval  length- 
ened. For  the  bottle  fed  baby,  the  feeding 
interval  should  be  lengthened,  two  teaspoon- 
fuls  of  lime  water  added  to  each  feeding  and  a 
smaller  quantity  of  milk  used  for  the  feeding. 
Less  sugar  should  be  added  to  the  formula. 
If  these  measures  do  not  stop  the  vomiting, 
the  milk  should  be  boiled  and  the  sugar  omit- 
ted entirely.  Mild  attacks  of  vomiting  may 
be  relieved  by  one  quarter  teaspoonful  of 
bicarbonate   of   soda   in   one   teaspoonful   of 


I    lurtesy  Manhattan  Maternity  Hospital,  N.  Y. 

Method  of  Syringing  the  Ear 


STOMACH    AND     BOWEL    DISORDERS        131 

water  or  fifteen  drops  of  rhubarb  and  soda 
mixture  in  a  teaspoonful  of  water. 

STOOLS 

For  the  first  few  days  of  life  the  bowel 
movements  are  black  and  sticky,  and  occur 
from  tw^o  to  four  times  a  day.  After  the  first 
week  they  become  yellow,  about  the  consist- 
ency of  gruel.  Later  they  are  of  a  paler  yellow, 
firmer  and  well  formed.  There  may  then  be 
from  three  to  four  movements  a  day,  if  the 
baby  is  breast  fed,  or  two  to  three  if  the  baby 
is  bottle  fed.  Occasionally  babies  have  only 
one  movement  a  day.  If  this  is  of  good 
quality,  no  concern  need  be  felt. 

Abnormal  Stools 

If  the  bowel  movements  contain  curds  or 
lumps  of  mucus,  it  is  an  indication  that  the 
milk  is  not  being  digested  properly.  When 
the  number  of  movements  in  a  day  exceeds 
four,  and  they  are  loose  or  watery  in  character, 
mixed  with  undigested  food,  sometimes  green- 
ish in  color,  there  evidently  is  some  distinct 
trouble  with  the  feeding,  and  proper  attention 
must  be  paid  to  the  matter  at  once.  Stools 
that  are  frothy,  rancid,  green,  liquid  in  char- 
acter and  frequent  in  number,  usually  are  due 
to  an  excess  of  sugar  or  fat  in  the  feeding. 
The  appearance  of  such  stools  may  not  be 


132  HEALTHY    BABIES 

accompanied  by  any  constitutional  symptoms. 
The  baby  may  be  restless,  but  usually  there 
is  no  fever  or  any  evidence  of  pain.  There  may 
be  gas  or  colic.  The  baby's  weight  remains 
stationary  or  there  may  be  a  loss. 

Treatment 

The  formula  should  be  made  with  skimmed 
milk,  with  all  sugar  omitted.  In  hot  weather 
the  milk  must  be  boiled.  Water  should  be 
given  freely  between  feedings,  and  the  inter- 
vals between  feedings  lengthened-  Restora- 
tion of  the  milk  formula  to  its  normal  strength 
must  be  carried  on  gradually,  the  reduced 
formula  being  used  for  at  least  a  week,  unless 
the  baby  shows  marked  loss  of  weight  in  the 
meantime,  when  the  amount  of  milk  in  the 
feedings  may  be  increased  or  whole  milk  may 
be  used  in  place  of  skimmed  milk,  but  no 
sugar  should  be  added  until  the  bowels  are 
entirely  normal. 

DIARRHOEA 

With  true  diarrhoea  there  is  a  good  deal  of 
gas  or  wind  passed  by  the  bowels,  and  the 
baby  usually  has  some  fever,  is  very  irritable 
and  cries  a  great  deal  of  the  time.  The  ab- 
domen may  be  hard  and  tense,  and  there  may 
be  other  evidence  of  pain  and  discomfort. 
Diarrhoea  is  very  uncommon  in  breast  fed 


STOMACH    AND     BOWEL    DISORDERS        133 

babies.  When  it  occurs  it  may  be  due  to 
diminished  vitaHty  as  a  result  of  very  hot 
weather,  or  to  overclothing.  In  bottle  fed 
babies,  however,  diarrhoea  is  common,  partic- 
ularly during  the  summer  months.  It  may  be 
due  to  overheating  of  the  body,  with  too  much 
clothing,  or  to  irregular  hours  of  feeding,  or  to 
too  frequent  feeding,  too  much  sugar  in  the 
milk,  or  particularly  to  milk  which  is  not 
entirely  fresh  or  which  has  not  been  kept 
properly  iced  and  covered.  As  diarrhoea  in 
bottle  fed  infants  may  be  a  serious  illness, 
active  measures  of  treatment  should  be  in- 
stituted at  once. 

Treatment 

All  milk  feedings  should  be  stopped  im- 
mediately and  the  baby  should  be  given  a 
tablespoonful  of  castor  oil.  If  the  baby  will 
not  take  castor  oil  or  vomits  it  immediately 
after  taking,  give  calomel  in  one-tenth  grain 
doses  every  fifteen  minutes  until  ten  doses  have 
been  taken.  For  twenty-four  hours  there 
should  be  no  food  except  barley  water,  rice 
water  or  albumen  water,  two  ounces  every 
two  hours.  Between  feedings  give  plenty  of 
cool,  boiled  water.  During  the  illness  the  baby 
must  stay  in  bed.  If  it  is  impossible  to  obtain 
the  doctor's  advice,  and  the  child  is  very  ill, 
the  mother  can  give  a  colon  irrigation.     If 


134  HEALTHY    BABIES 

the  baby  has  cold  hands  and  feet,  or  if  his 
legs  and  mucous  membranes  are  blue,  he 
should  be  given  a  mustard  bath,  then  wrapped 
in  a  blanket  with  a  hot  water  bag  at  his  feet, 
and  if  necessary  one  on  either  side  of  the  body. 
If  the  fever  is  very  high,  cool  or  tepid  sponge 
baths  should  be  given  two  or  three  times  a 
day.  Patent  medicine  should  never  be  given 
to  a  baby  except  on  the  advice  of  a  physician, 
nor  should  any  preparations  containing  opium 
or  alcohol  be  given.  They  are  apt  to  do  far 
more  harm  than  good,  and  may  be  exceed- 
ingly dangerous  in  some  cases. 

At  the  end  of  twenty-four  hours,  if  the 
diarrhoea  has  lessened,  nursing  should  begin 
again,  but  should  not  last  more  than  five 
minutes  and  should  be  kept  at  four-hour 
intervals.  For  the  bottle  fed  baby,  the 
milk  must  be  greatly  diluted,  a  formula  be- 
ing used  that  ordinarily  is  suited  to  a  much 
younger  child.  The  breast  fed  baby  should 
have  at  least  two  ounces  of  water  after 
the  five-minute  feeding.  Frequent  cool 
sponge  baths  and  the  very  lightest  of  cloth- 
ing are  essential.  If  the  diarrhoea  does  not 
stop  at  the  end  of  twenty-four  hours,  there 
should  be  no  delay  in  getting  the  advice  of  a 
physician. 


STOMACH    AND    BOWEL    DISORDERS      135 

Prevention  of  Diarrhoea 

It  is  much  easier  to  prevent  diarrhoea  in 
babies  than  it  is  to  cure  it.  Particular  care 
should  be  taken  at  the  beginning  of  the  hot 
weather  to  see  that  the  milk  supply  is  pure 
and  that  it  is  kept  cool,  clean  and  covered 
from  the  moment  it  reaches  the  home  until 
it  is  fed  to  the  baby.  During  the  hot  weather 
the  milk  should  be  pasteurized,  and  if  there 
is  any  doubt  at  all  about  its  purity  or  any 
difficulty  in  keeping  it,  the  milk  should  be 
boiled.  If  there  is  any  tendency  to  constipa- 
tion after  boiled  milk  has  been  used,  an  in- 
creased amount  of  sugar  may  be  added  to  the 
formula.  Throughout  the  hot  weather  the 
baby's  clothing  should  be  very  light  and  loose. 
Cool  boiled  water  must  be  given  between 
feedings  and  the  feeding  interval  lengthened. 
It  is  best  that  no  increase  in  the  strength  of 
the  milk  be  made  during  the  summer  months, 
unless  the  child  is  actually  losing  weight. 
During  the  heated  term  it  is  unusual  for  in- 
fants to  gain  to  any  extent,  but  this  does  not 
indicate  that  they  are  not  healthy.  The  baby 
must  be  kept  outdoors  as  much  as  possible, 
must  have  cool  sponge  baths  at  least  twice  a 
day  and  must  be  kept  free  from  all  unnecessary 
handling  and  over-excitement.  If  diarrhoea 
does  occur,  it  should  be  cared  for  as  outlined 
above. 


136  HEALTHYBABIES 

CONSTIPA  TION 

Constipation  in  breast  fed  babies  is  very- 
rare.  In  bottle  fed  babies  it  usually  is  due  to 
improper  diet  or  to  lack  of  muscular  strength 
in  the  intestines. 

Treatment 

In  the  case  of  a  breast  fed  baby  it  is  neces- 
sary for  the  mother  to  increase  the  amount  of 
fat  in  her  diet.  This  may  take  the  form  of 
extra  milk,  cream,  butter  or  olive  oil  in  tea- 
spoonful  doses  three  times  a  day.  The  baby 
may  be  given  a  teaspoonful  of  cream  in  a 
little  water  before  each  breast  feeding  or  half 
a  teaspoonful  of  olive  oil  after  the  morning, 
noon  and  evening  feedings.  In  a  bottle  fed 
baby  constipation  may  also  be  due  to  lack  of 
sufficient  fat  in  the  feeding,  although  often  it 
is  due  to  insufficient  water.  If  the  baby  is 
over  six  months  old  the  constipation  may  in- 
dicate that  he  has  been  kept  too  long  on  a 
.milk  diet,  and  needs  additional  food.  Boiled 
milk,  if  long  continued,  also  has  a  tendency 
to  cause  constipation.  In  such  cases,  orange 
juice  should  be  given  in  the  morning  in  table- 
spoonful  doses  at  least  one  hour  before  the 
first  feeding.  Water  must  be  given  in  suf- 
ficient quantity  between  feedings.  If  boiled 
milk  is  essential,   an  extra  tablespoonful  of 


STOMACH    AND     BOWEL    DISORDERS      137 

sugar  should  be  added  to  the  day's  mixture. 
One  teaspoonful  of  cream  may  be  added  to 
each  feeding  or  a  teaspoonful  of  olive  oil  may 
be  given  three  times  a  day.  Drugs  should 
not  be  used,  other  than  milk  of  magnesia 
which  gives  good  results  when  one  teaspoonful 
is  added  to  the  morning  and  night  feedings. 
After  the  baby  is  three  to  four  months  old 
oatmeal  water  should  be  substituted  for  the 
barley  water  in  making  the  formula,  and  at 
the  end  of  ten  months  the  child  may  be  given 
the  finely  mashed  pulp  of  some  stewed  prunes 
or  a  little  baked  apple  each  morning.  It  is 
important  to  establish  regular  habits,  and 
the  child  should  be  taken  to  the  stool  at  the 
same  hour  every  morning. 

COLIC  AND  WIND 

Colic  is  one  of  the  common  disturbances  of 
baby  life.  Usually  it  is  caused  by  over-feeding, 
too  rich  milk,  too  frequent  feeding,  too  much 
sugar  in  the  milk,  or  irregularity  in  feeding. 
Some  babies  habitually  gulp  up  quantities  of 
wind  from  the  stomach,  and  usually  all  that 
is  necessary  to  start  the  eructation  of  the  gas 
is  to  place  the  child  gently  over  the  mother's 
shoulder  and  pat  him  on  the  back.  Sometimes, 
however,  the  symptoms  are  more  severe.  The 
baby  may  show  signs  of  great  distress,  the 
face   becoming    blue    and    the    muscles    con- 


138  HEALTHYBABIES 

tracted.  The  child  draws  up  his  feet  and 
legs,  the  abdomen  becomes  hard  and  tense. 
The  cry  of  colic  is  quite  characteristic.  Gen- 
erally it  is  sudden,  sharp  and  strong,  and  to 
the  trained  ear  always  means  that  the  baby 
is  suffering  pain.  The  immediate  treatment 
is  to  place  the  baby  across  the  mother's  lap 
on  his  stomach  and  pat  the  back  gently,  or 
he  may  be  held  against  the  mother's  shoulder 
and  his  back  rubbed  or  patted  in  the  same  way. 
Placing  the  baby  face  downward,  with  the 
stomach  directly  over  a  hot  water  bag,  some- 
times gives  relief,  care  being  taken  to  see  that 
the  bag  is  not  too  hot.  Hot  fomentations  on 
the  baby's  abdomen  also  are  helpful.  The 
remedies  which  may  be  used  consist  of  five 
drops  of  peppermint  water  in  a  teaspoonful  of 
warm  water,  or  a  quarter  teaspoonful  of  soda 
bicarbonate  in  a  teaspoonful  of  hot  water. 
Usually,  after  any  of  these  remedies,  there  will 
be  a  sharp  eructation  of  gas,  and  the  child  will 
begin  to  show  relief.  If  the  gas  is  in  the  bowels 
the  abdomen  may  be  massaged  gently  or 
rubbed,  to  start  the  wind.  If  this  is  not  suf- 
ficient, a  rectal  injection  of  a  pint  of  warm 
water  w4th  five  drops  of  turpentine  may  be 
tried.  This  should  be  allowed  to  run  into  the 
rectum  very  gently,  and  when  expelled  usually 
will  bring  with  it  quantities  of  the  gas. 


STOMACH    AND     BOWEL    DISORDERS      139 

Prevention  of  Colic  and  Wind- 
To  prevent  colic  change  must  be  made  in 
the  manner  of  feeding.  Regular  hours  are  es- 
sential. The  interval  between  feedings  must 
be  lengthened.  In  breast  fed  babies  two  ounces 
of  water  should  be  given  from  a  nursing  bottle 
after  each  feeding. 

MALNUTRITION  AND  MARASMUS 

When  the  child  has  persistent  malnutrition 
which  is  shown  by  inability  to  digest  food,  and 
by  progressive  loss  in  weight,  or  when  the  loss 
of  body  weight  is  so  excessive  that  the  child  is 
actually  emaciated,  the  condition  is  known  as 
marasmus.  This  condition  is  far  more  common 
among  babies  in  institutions  than  amiong  those 
who  are  cared  for  at  home.  The  general 
methods  of  hygienic  care  and  right  feeding  are 
the  best  preventives,  but  prolonged  malnutri- 
tion or  marasmus  may  be  the  result  of  some 
special  disease.  While  any  baby  in  this  condi- 
tion should  be  under  the  immediate  care  of  a 
physician,  a  few  suggestions  may  be  given  to 
the  mother. 

Sometimes  this  condition  of  lack  of  nourish- 
ment is  due  to  too  strong  milk  mixtures  in  the 
artificially  fed  baby.  Overfeeding  also  may 
be  a  cause.  In  this,  as  in  every  other  matter 
concerning  the  baby,  weight  is  the  best  indica- 


140  HEALTHY    BABIES 

tion  of  continued  progress.  When  it  remains 
stationary  for  any  length  of  time,  or  continues 
to  grow  less,  it  is  evident  that  the  food  is  not 
agreeing  with  the  baby.  All  other  matters 
pertaining  to  improper  baby  hygiene  are  caus- 
ative factors.  Because  the  causes  are  so 
many,  no  regular  rules  can  be  given  as  to 
treatment. 

If  it  is  possible  to  obtain  a  wet  nurse  for 
the  baby,  this  should  be  tried  at  once.  Very 
weak  dilutions  of  milk  may  have  to  be  given 
for  a  time.  If  the  weight  is  increasing  slightly, 
do  not  increase  the  amount  of  food  or  force 
the  feeding  in  order  to  increase  the  weight  still 
more.  Symptoms  of  vomiting  and  diarrhoea 
should  be  treated,  but  it  must  be  remembered 
that  these  babies  need  more  intelligent  care 
than  the  normal  baby.  Fresh  air  is  of  the 
utmost  importance  and  the  baby  should  be 
kept  outdoors  as  nearly  as  possible  all  of  the 
twenty-four  hours.  Salt  baths,  gentle  rubbing 
from  head  to  feet  with  olive  oil  or  cocoa  butter, 
are  excellent.  This  rubbing  should  always  be 
toward  the  body;  that  is,  beginning  at  the 
feet  and  making  the  movements  up  the  legs, 
or  beginning  at  the  hands,  and  stroking  up 
the  arms.  This  should  always  be  done  very 
gently. 

Such  babies  should  never  be  allowed  to  re- 
main very  long  in  one  position.     Even  while 


STOMACH    AND     BOWEL    DISORDERS      141 

they  are  sleeping,  they  should  be  moved. 
Mothers  always  should  take  up  these  ill- 
nourished  babies  several  times  a  day,  and  walk 
around  the  room  with  them  and  hold  them  in 
their  laps.  While  all  these  matters  may  help, 
and  sometimes  may  effect  a  cure,  the  mother 
should  never  forget  the  importance  of  obtain- 
ing the  best  possible  medical  advice  for  her 
under-nourished  baby. 


CHAPTER  VIII 

MINOR  ILLNESSES  AND  AILMENTS 

HOW  TO  DETECT  SYMPTOMS  OF  ILLNESS 

The  four  main  ways  in  which  illness  is  shown 
are  (1)  appearance  of  the  patient,  (2)  rise  in 
temperature,  (3)  increase  in  pulse  rate,  and 
(4)  increase  in  the  respiratory  rate. 

Observation 

While  different  diseases  have  different  symp- 
toms, in  general  the  first  signs  of  illness  in  a 
child  consist  in  slight  flushing  of  the  face,  ir- 
ritability, restlessness,  sleeplessness  and  lack 
of  appetite.  These  signs  are  readily  apparent. 
There  are  others  which  may  be  observed  more 
readily  when  the  baby  is  asleep.  If  he  is  well, 
the  sleep  will  be  quiet  and  peaceful.  There 
should  be  no  movement,  restlessness  or  tossing 
about.  In  the  normal  baby,  breathing  is 
regular,  easy  and  quiet,  and  he  should  always 
breathe  through  the  nose,  with  the  mouth 
closed.  If  he  is  well,  the  skin  should  feel 
cool  and  slightly  moist.  Hands  and  feet 
should  always  be  warm,  and  the  skin  always 
should  be  a  healthy  pink  color. 

Temperature 

The  normal  temperature  of  the  body  is  98.6 
degrees  Fahrenheit.  Babies  show  more  marked 

142 


MINOR    ILLNESSES    AND    AILMENTS        143 

changes  in  temperature  than  adults  do.  The 
cause  of  a  high  temperature  in  a  baby  may 
be  very  sHght,  and  the  temperature  may  go 
up  to  103  or  104  degrees  for  a  Httle  digestive 
disturbance,  or  an  illness  which  need  give  no 
cause  for  concern.  The  only  time  when  an 
increase  in  temperature  is  to  be  considered  is 
when  it  persists  longer  than  six  hours.  The 
temperature  always  is  slightly  higher  at  night 
than  it  is  in  the  morning.  Some  children 
have  a  temperature  which  always  is  above 
normal  and  some,  particularly  those  who  are 
poorly  nourished,  have  a  temperature  which 
is  consistently  below  normal. 

Use  of  the  Thermometer 

The  ordinary  clinical  thermometer  must 
receive  proper  care.  It  always  should  be 
washed  in  cold  water  immediately  before  and 
immediately  after  using.  It  never  should  be 
put  in  a  warm  place  or  washed  with  hot 
water.  If  this  is  done  the  bulb  of  mercury 
at  the  end  of  the  thermometer  will  break. 
Usually  it  is  necessary  for  a  person  to  be  in- 
structed in  reading  the  thermometer,  and  every 
mother  should  obtain  from  her  doctor  or  nurse 
the  proper  training  in  this  regard.  The  baby's 
thermometer  should  be  kept  for  his  use  alone. 
Before  using,  see  that  the  indicator  is  at£a 
point  below  97  degrees.     If  it  is  not,  the  ther- 


144  HEALTHY    BABIES 

mometer  must  be  shaken  very  gently  until 
the  mercury  goes  down  to  that  point. 

How  to  Take  the  Temperature 

The  baby  should  be  placed  on  his  stomach 
on  the  mother's  lap,  or  he  may  be  held  on  his 
back,  the  ankles  grasped  and  the  legs  held  at 
right  angles  to  his  body.  The  bulb  end  of  the 
thermometer  is  greased  with  vaseline,  the  fold 
between  the  buttocks  gently  separated,  and 
the  thermometer  inserted  into  the  rectum  for 
about  one  inch.  It  should  be  kept  in  place 
for  from  one  to  two  minutes,  depending  upon 
the  type  of  thermometer  used.  It  is  well  to 
accustom  the  baby  to  the  taking  of  his  tem- 
perature, even  when  he  is  not  sick,  so  that,  if 
sickness  occurs,  he  will  not  be  unduly  fright- 
ened or  worried  when  the  thermometer  is  used. 
The  normal  body  temperature  taken  with  the 
thermometer  in  the  mouth  is  98.4.  The  rectal 
temperature  is  about  one  degree  higher,  but 
because  babies  have  such  wide  variations  of 
temperature  in  any  event,  a  rectal  temperature 
in  an  infant  need  not  be  considered  subnormal 
unless  it  is  below  97.6,  and  it  need  not  be 
thought  that  the  baby  has  a  fever  unless  the 
rectal  temperature  goes  above  100.6.  The 
length  of  time  the  fever  lasts  is  far  more  im- 
portant than  the  height  it  reaches. 


MINOR    ILLNESSES    AND    AILMENTS        145 

A  word  of  warning  should  be  given  against 
placing  too  implicit  reliance  upon  the  use  of 
a  thermometer.  Many  mothers  have  worried 
unnecessarily  regarding  their  children  because 
of  the  habit  of  taking  temperatures  every  day. 
It  is  not  necessary,  nor  is  it  wise,  to  take  the 
baby's  temperature  unless  there  is  some  indi- 
cation of  illness.  (See  illustration  opposite 
page  66.) 

Pulse 

All  babies  have  a  very  rapid  pulse.  The 
number  of  beats  in  each  minute  decreases  as 
the  child  grows  older.  Because  the  pulse  is 
so  rapid,  it  is  difficult  for  anyone  but  a  physi- 
cian or  a  trained  nurse  to  determine  whether 
the  number  of  pulse  beats  per  minute  is  more 
than  normal.  If  the  child  has  a  fever,  there 
is  an  increase  in  the  pulse  rate.  The  duration 
of  these  conditions  only  need  be  considered  as 
of  any  particular  importance.  In  certain  dis- 
eases, particularly  those  which  affect  the  brain, 
there  is  an  unduly  slow  pulse  rate.  The  same 
word  of  warning  is  attached  to  taking  the 
pulse  rate  that  has  already  been  given  with 
regard  to  taking  the  temperature.  There  rare- 
ly are  any  occasions  when  the  mother  need 
take  the  pulse,  and  certainly  she  should  not 
do  so  unless  marked  symptoms  of  illness  are 
present. 


146  HEALTHYBABIES 

How  to  Take  the  Pulse 

The  best  way  to  feel  the  pulse  is  to  place 
the  forefinger  of  the  right  hand  directly  on 
the  baby's  right  wrist,  just  at  the  base  of  the 
thumb.  A  little  practice  will  show  the  spot 
where  the  beating  of  the  artery  can  be  felt 
most  easily.  While  the  normal  pulse  of  a  grown 
person  is  between  seventy  and  eighty,  the 
normal  pulse  of  a  baby  at  birth  is  between  one 
hundred  forty,  and  one  hundred  fifty.  At  one 
month  this  has  decreased  to  between  one 
hundred  thirty,  and  one  hundred  forty,  while 
at  six  months  the  pulse  should  not  be  higher 
than  one  hundred  twenty.  Usually  it  remains 
at  about  this  rate  during  the  remainder  of  the 
first  year,  while  during  the  second  year  of  life 
it  should  be  between  one  hundred  and  one 
hundred  ten. 

Respiration 

The  frequency  of  a  baby's  respiration  is  not 
so  important  as  its  type.  When  the  child  is 
sick,  it  may  be  of  importance  to  the  doctor  to 
have  a  record  as  to  whether  or  not  breathing 
has  been  irregular,  noisy  or  difficult;  also,  in 
some  instances  it  may  be  of  value  to  know 
whether  it  has  been  rapid. 

In  common  with  the  pulse,  the  respiratory 
rate  of  infancy  is  much  higher  than  that  of 
later  life.    The  ordinary  respiratory  rate  in  an 


MINOR    ILLNESSES    AND    AILMENTS        147 

adult  is  about  eighteen  per  minute;  that  is, 
eighteen  complete  breaths  are  inhaled  and  ex- 
haled in  sixty  seconds.  In  a  new  born  baby 
the  rate  of  respiration  is  about  forty  per 
minute,  which  decreases  to  thirty  at  the  end 
of  the  first  year,  and  is  still  further  reduced 
to  twenty-six  when  the  child  is  about  two 
years  old. 

CONVULSIONS  OR  SPASMS 

Convulsions  may  be  the  first  indication  of 
the  onset  of  an  acute  illness,  or  they  may 
occur  in  a  child  otherwise  apparently  healthy, 
who,  after  the  convulsion  is  over,  may  seem 
to  be  as  well  as  ever.  Always  there  is  a  ten- 
dency for  convulsions  to  be  repeated,  unless 
proper  action  is  taken  to  prevent  them,  and 
the  more  often  they  are  repeated,  the  more 
fixed  becomes  the  habit.  For  this  reason, 
every  effort  must  be  made  to  see  not  only  that 
the  convulsions  are  treated  at  once,  but  that 
proper  care  is  instituted  to  prevent  their  oc- 
currence in  future. 

Causes  of  Convulsions  or  Spasms 

The  ordinary  convulsion  which  occurs  in  a 
child  otherwise  in  perfect  health  usually  is  cau- 
sed by  some  digestive  disturbance,  due  to  some 
error  in  diet.  Other  causes  of  convulsions  are 
diseases  like  rickets,  whooping  cough  or  acute 


148  HEALTHY    BABIES 

illnesses  of  various  kinds.  In  boys,  tight  fore- 
skin, which  is  an  indication  for  circumcision, 
may  cause  convulsions  by  mechanical  irrita- 
tion. Children  who  are  poorly  nourished  may 
have  repeated  convulsions  for  no  apparent 
reason.  Spasms  of  this  kind  are  practically 
unknown  to  occur  as  a  result  of  worms  or  of 
teething. 

Symptoms 

In  some  instances  the  symptoms  are  slight. 
The  baby's  body  will  become  stiff,  the  eyes 
fixed.  If  the  baby  is  a  runabout,  he  may  be 
walking  and  stop  suddenly  staring  into  vac- 
ancy. The  young  baby  will  lie  perfectly  rigid 
and  quiet.  The  duration  of  the  spasm  is  very 
short  and  the  child  recovers  almost  immedi- 
ately, and  seems  as  well  as  ever. 

More  Severe  Type 

In  such  instances  the  child's  muscles  begin 
to  twitch,  the  whole  body  stiffens,  the  hands 
clinch,  the  eyes  have  a  fixed  and  vacant  look, 
the  forehead  usually  perspires  freely  and  is 
cold.  The  child  becomes  unconscious,  with 
feeble  breathing,  and  will  remain  in  this  con- 
dition for  several  minutes  unless  active  meas- 
ures are  taken  to  combat  the  spasm. 


MINOR     ILLNESSES    AND     AILMENTS        149 

Treatment 

If  the  child  can  be  undressed  at  once,  he 
should  be  placed  in  a  mustard  bath.  Care 
must  be  taken  to  see  that  the  water  is  not  too 
warm.  The  best  way  to  test  it  is  to  have  the 
mother  or  attendant  place  her  elbow  into  the 
water.  If  it  feels  warm  but  not  hot,  it  will 
not  burn  the  child.  If  a  thermometer  is  avail- 
able, the  water  should  be  prepared  at  a  tem- 
perature of  102  to  104  degrees.  If  there  is 
not  time  to  undress  the  child,  the  shoes  arid 
stockings  should  be  removed,  the  child  placed 
flat  on  his  back  on  the  edge  of  the  bed  or  table, 
and  the  feet  allowed  to  hang  into  a  mustard 
foot  bath  of  the  temperature  mentioned  above. 
Whether  the  full  mustard  bath  or  the  mustard 
foot  bath  is  given,  a  cloth  wet  with  cold 
water  or  an  icebag  should  be  placed  at  the 
child's  head.  The  bath  should  continue  for 
from  five  to  ten  minutes.  The  feet  or  the  body 
should  be  rubbed  gently  during  this  entire 
time.  Then  the  child  should  be  wrapped  in  a 
warm  blanket,  the  icebag  or  iced  cloth  kept 
on  his  head  and  a  hot  water  bag  placed  at 
his  feet.  As  soon  as  it  can  be  prepared  an 
enema  of  warm  soapsuds  should  be  given  in 
order  to  remove  from  the  lower  bowel  any 
feces  that  may  be  there.  A  teaspoonful  to  a 
tablespoonful  of  castor  oil  should  be  given, 


150  HEALTHYBABIES 

depending  upon  the  age  of  the  child,  and  he 
should  be  induced  to  sleep.  Medical  advice 
must  be  obtained  for  any  child  who  has  more 
than  one  convulsion.  It  is  not  safe  to  assume 
that  he  will  outgrow  them,  nor  is  it  safe  simply 
to  follow  these  methods  of  treatment  that  the 
mother  may  understand.  After  any  convul- 
sion, great  care  must  be  taken  in  regard  to  the 
feeding.  For  several  hours  the  child  should 
have  nothing  but  water  to  drink  and  no  food 
of  any  kind.  When  feeding  is  resumed,  it  must 
be  exceedingly  light.  In  young  babies,  the 
milk  should  be  reduced  one-half  in  quality  by 
adding  an  equal  amount  of  water.  Although 
convulsions  occur  very  rarely  in  breast  fed 
babies,  if  they  do  occur  the  baby  should  be 
nursed  only  half  the  usual  time,  and  then  be 
given  water  to  drink. 

WORMS 

Thread  worms  are  the  only  type  which  occur 
in  babies  under  one  year  of  age,  and  it  is  rare 
for  any  symptoms  to  accompany  these  worms. 
The  tape  worm  and  other  varieties  of  in- 
testinal worms  are  not  found  until  the  child 
begins  to  eat  solid  food.  The  only  way  in 
which  thread  worms  can  be  diagnosed  is  by 
finding  them  in  the  baby's  stools.  They  occur 
as  small,  white  threads,  and  if  watched  closely, 


MINOR     ILLNESSES    AND     AILMENTS        151 

may  be  seen  to  move.    Occasionally  the  eggs 
of  the  worms  are  found. 

Treatment 

Irrigate  the  lower  bowel  with  a  solution  of  a 
tablespoonful  of  salt  to  a  quart  of  water,  or  a 
solution  of  two  tablespoonfuls  of  borax  to  a 
quart  of  water.  This  solution  should  be  allow- 
ed to  run  in  and  out  very  slowly,  and  should 
reach  as  high  into  the  bowel  as  possible.  After 
this  has  been  ejected  completely,  a  solution  of 
quassia  should  be  injected  slowly.  This  is 
made  by  adding  one  ounce  of  quassia  chips  to 
eight  ounces  of  water,  bringing  it  to  a  boil, 
and  straining.  The  irrigation  of  the  bowel  and 
the  injection  of  the  quassia  water  should  be 
repeated  every  day  for  three  days.  After  that 
it  may  be  done  less  frequently.  The  bowel 
movements  must  be  examined  every  day  to 
determine  whether  or  not  the  worms  are  pres- 
ent. Particular  care  must  be  taken  to  examine 
the  external  genitals  so  that  the  baby  may  not 
become  reinfected.  It  is  not  uncommon  for 
the  worms  to  remain  hidden  about  the  baby's 
genitals,  and  later  to  reach  the  rectum,  setting 
up  a  reinfection. 

RICKETS 

This  is  a  disease  w^hich  is  due  to  some  nu- 
tritional disorder.     It  is  chronic  in  character. 


152  HEALTHYBABIES 

The  bones  show  the  effects  of  rickets  more 
clearly  than  any  other  part  of  the  body.  It 
is  apt  to  manifest  its  symptoms  after  the 
baby  is  six  months  old,  although  the  first 
symptoms  may  appear  later,  up  to  two  and 
a  half  to  three  years  old. 

Cause 

A  certain  amount  of  the  undernourishment 
which  leads  to  rickets  is  due  to  lack  of  prenatal 
care,  because  the  mother's  diet  during  her 
pregnant  period  has  not  supplied  the  child 
with  the  necessary  materials  for  developing 
the  bones  in  a  normal  manner.  After  the  birth 
of  the  child,  rickets  may  occur  as  a  result  of 
too  prolonged  use  of  the  various  proprietary 
foods,  unless  they  are  made  up  with  plenty  of 
fresh  milk.  Lack  of  fat  or  cream  in  the  diet 
also  frequently  leads  to  the  occurrence  of 
rickets. 

Symptoms 

The  symptoms  of  rickets  are  only  fairly  well 
defined  in  their  early  stage.  At  first  all  that  may 
be  noticed  is  that  the  child  becomes  increasing- 
ly restless  and  frequently  there  may  be  some 
pallor  and  anemia.  Sleep  is  disturbed.  The 
characteristic  symptom  is  marked  sweating  of 
the  head,  particularly  at  night.  It  is  not  un- 
common to  find  the  baby's  pillow  quite  wet.   As 


MINOR    ILLNESSES    AND     AILMENTS        153 

the  disease  progresses  there  are  more  marked 
bodily  changes.  The  pot-belly  abdomen  is 
often  the  first  symptom  noticed.  Here  the 
abdomen  becomes  very  large  in  proportion  to 
the  rest  of  the  body  and  stands  out  promi- 
nently. Children  with  rickets  always  are  late 
in  showing  the  normal  signs  of  development. 
Sitting  up,  creeping  and  walking  will  occur 
several  months  after  the  proper  time.  Denti- 
tion is  apt  to  be  very  much  delayed.  If  treat- 
ment is  not  started  early,  we  have  the  per- 
manent results  of  rickets  which  are  apt  to  be 
serious.  As  softening  of  the  bones  is  char- 
acteristic of  the  disease,  children  who  are 
allowed  to  walk  too  early  are  apt  to  become 
bow-legged.  In  any  event  the  bones  become 
enlarged  and  may  be  deformed.  The  head  is 
over-size  in  proportion  to  the  growth  of  the 
rest  of  the  body,  and  the  top  of  the  head  is 
apt  to  be  flat.  The  wrist  and  ankle  bones  may 
show  signs  of  enlargement.  Frequently  the 
chest  is  deformed,  and  on  each  rib  in  front 
appears  a  small,  hard  nodule  of  bone.  As  these 
nodules  appear  in  about  the  same  place  on 
each  rib,  they  can  be  felt  on  each  rib  and  form 
what  is  known  as  the  "rachitic  rosary." 
Children  who  have  rickets  are  subject  to  many 
symptoms  of  illness.  They  are  apt  to  be 
constipated  and  to  have  various  types  of  in- 


154  HE  A  LTHY    B  A  B  I  ES 

testinal  trouble.     Convulsions  are  not  uncom- 
mon in  rachitic  children. 

Treatment 

As  rickets  is  a  nutritional  disease,  the  way 
to  treat  it  is  to  change  the  diet.  If  it  has 
been  caused  by  too  prolonged  use  of  propri- 
etary foods  made  without  milk  an  absolute 
change  in  the  manner  of  feeding  must  be  made 
at  once.  Fresh  milk  always  should  be  part 
of  the  dietary.  If  the  milk  must  be  pasteur- 
ized or  boiled,  orange  juice,  prune  juice  or  the 
juice  of  canned  tomatoes  should  be  given,  at 
least  two  teaspoonfuls  of  the  juice  each  day. 
If  there  is  a  tendency  to  rickets,  beef  juice, 
the  white  of  coddled  eggs  and  vegetable  broths 
may  be  added  at  the  age  of  six  months. 
Special  attention  must  be  paid  to  the  bowel 
action  of  such  children,  and  it  is  essential  that 
they  have  a  free  movement  once  each  day. 
Children  with  a  predisposition  to  rickets  or 
those  who  have  already  developed  the  disease 
should  stay  outdoors  the  greater  part  of  the 
day.  Sleeping  outdoors  is  one  of  the  best 
methods  of  treatment  we  know  anything 
about.  Medical  treatment  must  be  left  to 
the  physician,  but  it  is  permissible  to  use  cod 
liver  oil  in  doses  of  from  one  half  to  one  tea- 
spoonful  three  times  a  day  for  children  over 
nine  months  of  age. 


MINOR     ILLNESSES    AND     AILMENTS         155 
SCURVY 

Scurvy  is  a  nutritional  disease,  due  to  wrong 
feeding.  It  is  most  common  in  the  latter  part 
of  the  first  year  of  life,  when  the  baby's  need 
of  a  changed  diet  is  evident  although  milk 
feeding  is  still  continued.  However,  it  may 
occur  during  the  second  year,  if  the  child  is 
not  being  fed  properly. 

Cause 

The  most  common  cause  of  scurvy  is  too 
long  continued  use  of  one  type  of  food  so  that 
the  diet  is  not  properly  balanced.  In  infancy, 
therefore,  it  is  essential  to  see  that  the  child 
receives  some  fresh  food.  Frequently  it  hap- 
pens that  the  long-continued  use  of  proprie- 
tary foods,  boiled  milk  or  pasteurized  milk 
will  lead  to  the  occurrence  of  scurvy. 

Recent  investigations  have  shown  that  there 
are  certain  vital  food  elements  which  are 
known  as  vitamines  and  which  occur  in  var- 
ious types  of  fresh  foods,  including  raw  milk. 
They  also  occur  in  breast  milk.  It  is  pos- 
sible that  pasteurizing  or  sterlizing  the  milk 
destroys  them. 

Symptoms 

The  most  characteristic  sign  of  scurvy  is  sore- 
ness and  tenderness  of  the  bones.  This  occurs 
more  frequently  in  the  child's  legs  and  he  will 


156  HEALTHYBABIES 

cry  out  when  handled.  There  may  be  some 
swelHng  of  the  knees  and  ankles,  and  less  com- 
monly, of  the  other  joints  of  the  body.  This 
must  not  be  mistaken  for  rheumatism,  a  disease 
which  does  not  occur  in  children  under  one  year 
of  age.  As  the  baby  lies  in  bed,  he  seems  un- 
willing to  move  and  resents  being  handled  or 
lifted.  The  gums  frequently  are  swollen  and 
may  be  congested,  and  of  purplish  color.  They 
are  apt  to  bleed  and  this  bleeding  sometimes 
occurs  also  from  the  nose  and  bowels.  Fre- 
quently, in  advanced  cases,  the  child's  legs 
will  be  covered  with  what  seem  to  be  black 
and  blue  spots. 

Treatment 

The  treatment  of  this  disease  is  indicated 
by  what  is  given  as  the  cause.  The  proper  way 
to  prevent  scurvy  is  to  see  that,  after  three 
months  of  age,  the  baby  receives  every  morn- 
ing two  teaspoonfuls  of  orange  juice,  prune 
juice  or  the  strained  juice  of  canned  tomatoes 
at  least  one  hour  before  the  first  morning  feed- 
ing. This  is  particularly  necessary  if  the  baby 
is  being  fed  on  proprietary  foods  or  pasteurized 
milk.  Care  should  be  taken  that  weaning  is 
not  delayed  too  long.  Whenever  possible,  fresh 
milk  should  be  used.  At  least  some  proportion 
of  it  must  be  included  in  the  dietary,  even  if 
the  balance  of  the  food  is  of  another  character. 


MINOR     ILLNESSES    AND    AILMENTS        157 


If  the  symptoms  develop  when  the  child  is 
six  months  old  or  over,  it  is  well  to  add  to  the 
diet  a  little  of  the  mealy  part  of  a  baked 
potato,  a  teaspoonful  of  beef  juice  on  a  small 
piece  of  dry  bread  or  two  teaspoonfuls  of  apple 
sauce  or  the  white  of  a  coddled  ^gg.  These 
articles  should  be  given  alternately,  on  suc- 
ceeding days.  This  treatment  of  scurvy  will 
result  in  marked  improvement  of  the  condition 
and  usually  will  result  in  an  entire  cure  within 
three  weeks. 

SPRUE  AND  THRUSH 

A  common  complaint  of  infancy  is  known 
as  sprue  or  thrush.  The  symptoms  are  tiny 
white  threads  or  flakes  which  appear  on  the 
inner  side  of  the  lips  or  inside  the  cheeks 
The  whole  inside  of  the  mouth  and  tongue 
may  be  covered.  In  such  cases  it  may  be 
necessary  to  wash  out  the  baby's  mouth,  using 
a  solution  of  borax  or  soda  bicarbonate  (baking 
soda),  one  teaspoonful  to  three  ounces  of  water. 
This  may  be  done  twice  a  day.  Absorbent 
cotton  should  be  wound  around  the  little 
finger  of  the  mother,  then  dipped  into  the 
solution  and  applied  to  the  affected  surfaces 
with  a  gentle  rotary  motion  of  the  finger.  No 
force  whatever  should  be  used  for  the  delicate 
mucous  membrane  is  very  easily  injured. 


158  HEALTHYBABIES 

PRICKLY  HEAT 

Prickly  heat  consists  of  fine  red  pimples 
which  may  occur  all  over  the  body.  They  are 
noticeable  especially  where  there  has  been  ir- 
ritation or  undue  pressure  from  the  under- 
clothing. They  are  due  to  inflammation  of  the 
pores,  and  are  caused  by  excessive  perspira- 
tion or  the  irritation  from  flannel  undercloth- 
ing. To  avoid  prickly  heat,  the  body  should 
be  kept  cool  and  there  should  be  frequent 
cool  sponge  baths  during  the  hot  weather. 
Muslin  or  linen  always  should  be  worn  next  to 
the  skin.  This  is  proper  even  in  very  young 
babies. 

Treatment 

For  treatment,  bran  or  soda  baths  are  ad- 
vised. Sponge  baths  may  be  given  with  equal 
parts  of  vinegar  and  water.  The  skin  never 
should  be  rubbed,  but  always  patted  dry,  and 
after  any  kind  of  bath  should  be  well  dusted. 
For  a  baby  with  slight  prickly  heat  a  powder 
composed  of  one  part  boric  acid  to  four  parts 
powdered  starch  is  advised.  If  the  secretion 
is  excessive  or  the  itching  is  extreme,  a  powder 
made  of  one  part  zinc  oxide  to  five  parts  starch 
or  stearate  of  zinc  powder  will  be  found  to 
have  both  healing  and  soothing  qualities. 


MINOR     ILLNESSES    AND    AILMENTS        159 
EARACHE 

In  very  young  babies  symptoms  of  earache 
are  apt  to  be  obscure.  Usually  the  first  symp- 
tom is  loss  of  appetite,  followed  by  an  in- 
crease in  temperature,  the  fever  going  as  high 
as  103  to  105  degrees.  The  baby  is  drowsy  at 
first,  later  becoming  extremely  restless  with 
much  tossing  about.  Sometimes  the  child  may 
be  noticed  attempting  to  move  his  hand  up  to 
the  affected  ear.  Vomiting  is  not  uncommon. 
The  diagnosis  of  earache  in  a  young  infant  is 
not  easy,  therefore  it  is  necessary  to  deter- 
mine that  no  other  condition  exists  which 
would  cause  the  fever  and  apparent  pain. 
If  any  indication  exists  that  the  pain  is  in 
the  child's  head,  it  is  well  to  assume  that 
the  ear  may  possibly  be  involved  and  to 
proceed  accordingly. 

Treatment 

Heat  in  some  form  is  the  best  early  treat- 
ment. The  heat  should  be  dry  and  continuous. 
The  child's  head  should  be  allowed  to  lie 
against  a  hot  water  bag,  care  being  taken  to 
see  that  it  is  not  hot  enough  to  burn  the  baby's 
skin.  Bags  filled  with  salt  may  be  heated  in 
the  oven  and  wrapped  around  with  flannel. 
This  furnishes  a  good  method  of  applying  heat. 
If  the  symptoms  do  not  subside  with  this  hot 
application,  it  is  well  to  irrigate  the  ear  with 


160  HEALTHYBABIES 

a  very  warm  solution  of  boric  acid,  a  tea- 
spoonful  to  a  pint  of  water,  or  a  solution  of 
salt  and  warm  water,  a  teaspoonful  to  a  pint. 
If  the  pain  still  persists  after  the  irrigation,  a 
doctor  should  be  consulted  at  once,  for  it  may 
be  necessary  to  have  an  incision  made  in  the 
ear  drum.  Occasionally  the  ear  drum  will 
rupture  spontaneously,  and  after  that  there 
may  be  a  flow  of  pus  from  the  ear  for  several 
days.  As  long  as  this  pus  appears  the  irriga- 
tion should  be  carried  on  two  or  three  times  a 
day  and  the  ear  kept  absolutely  clean.  As 
soon  as  the  ear  drum  ruptures  or  is  perforated, 
the  symptoms  of  earache  will  subside  and  rarely 
return  unless  the  drum  heals  too  rapidly. 

Method  of  Irrigation 

There  are  two  methods  that  may  be  used 
in  irrigating  the  ear.  First  is  by  means  of  a 
fountain  syringe  at  a  height  of  two  feet  above 
the  head  of  the  child.  He  lies  on  his  back, 
turned  slightly  towards  the  side  of  the  ear  that 
is  affected.  A  shallow  basin  should  be  placed 
under  the  ear,  and  the  nozzle  of  the  fountain 
syringe  held  about  one  to  two  inches  above  the 
opening  of  the  ear  canal.  The  stream  should 
be  directed  towards  this  opening,  and  the 
water  should  be  allowed  to  flow  in  very  gently, 
and  to  flow  out  of  the  ear  freely  at  the  same 
time.   No  force  whatever  should  be  used.   One 


MINOR    ILLNESSES    AND     AILMENTS         161 

pint  of  the  solution  used  in  the  ear  is  quite 
enough.  The  second  method  is  by  means  of 
a  small  ear  syringe,  made  like  a  soft  rubber 
ball,  drawn  out  to  a  point  on  one  side.  This 
may  be  squeezed  and  filled  with  the  solution 
then  squeezed  gently  to  expel  the  contents  in 
the  baby's  ear  canal.  Care  must  be  taken  to 
see  that  no  pressure  is  directed  inside  the 
child's  ear,  and  that  the  water  flows  out  freely. 
After  the  irrigation  has  been  completed  the 
outside  of  the  ear  canal  should  be  wiped  out 
gently  with  absorbent  cotton.  (See  illustration 
opposite  page  131.) 

HICCOUGHS 

In  babies,  hiccoughs  usually  are  caused  by 
too  rapid  nursing  either  from  the  breast  or 
from  the  bottle.  Over-eating,  with  consequent 
indigestion  and  the  formation  of  gas  in  the 
stomach,  also  will  cause  hiccoughs. 

Treatment 

The  treatment  of  hiccoughs  consists  in  pre- 
vention; that  is,  care  of  the  diet  to  correct  any 
tendency  to  over-eating.  If  the  baby  is  bottle 
fed,  attention  must  be  paid  to  the  nipple  to 
see  that  the  milk  does  not  flow  through  in  too 
free  a  manner.  It  should  come  through  only 
a  drop  at  a  time.  The  baby  must  not  be 
allowed  to  nurse  too  rapidly,  and  a  full  twenty 


162  HEALTHYBABIES 

minutes  is  necessary  for  each  feeding.  For 
acute  attacks  of  hiccoughs  ten  drops  of  rhu- 
barb and  soda  mixture  in  a  teaspoonful  of 
water  or  one-quarter  teaspoonful  of  soda  bi- 
carbonate to  a  teaspoonful  of  water  usually 
will  relieve  the  attack.  If  there  is  much  gas 
formation  in  the  stomach  or  intestines,  a  colon 
irrigation  is  advised. 

SKIN  DISEASES 

ECZEMA 

Eczema  in  infancy  is  fairly  common.  It  is 
more  apt  to  occur  in  children  who  appear  well 
nourished,  and  who  are  healthy  looking  and 
fat.  It  may  occur  either  in  breast  fed  or  bottle 
fed  babies,  but  is  not  common  in  poorly  nour- 
ished children.  The  disease  probably  is  due 
to  both  internal  and  external  conditions.  Over- 
feeding of  milk  which  contains  too  much  fat 
is  responsible  for  many  cases.  Some  children, 
however,  have  a  certain  susceptibility  to 
eczema  and  it  continues  all  through  infancy, 
notwithstanding  everything  that  is  done  to 
prevent  or  relieve  it.  The  external  causes  are 
exposure  to  strong  winds  or  cold  outdoors. 
The  first  symptoms  noticed  are  usually  those 
of  chapping  of  the  face.  It  may  occur  also 
as  a  result  of  lack  of  cleanliness,  when  irritating 
discharges  from  the  bowels  or  other  bodily 


MINOR    ILLNESSES    AND     AILMENTS         163 

cavities  are  allowed  to  remain  for  any  length 
of  time.  Irritation  from  rough  clothing  also 
has  been  known  to  cause  eczematous  conditions. 

Location  of  Eczema 

Usually  eczema  appears  on  the  cheeks,  fore- 
head and  scalp,  although  it  may  occur  on 
almost  any  part  of  the  body.  Upon  the  trunk 
or  extremities  it  occurs  usually  in  patches. 
When  it  appears  on  the  scalp  it  is  sometimes 
referred  to  as  "milk  crust,"  and  is  seen  in  the 
form  of  a  yellow  or  grayish  secretion,  forming 
a  crust  which  covers  the  entire  head  of  the 
child.  The  first  symptoms  are  those  of  red- 
ness and  roughness  of  the  skin.  Later,  the 
skin  becomes  moist,  with  much  secretion. 
This  dries  and  forms  heavy  crusts  which  be- 
come hard  and  unyielding.  There  is  evidence 
that  eczema  causes  intense  itching. 

Treatment 

Attacks  of  eczema  rarely  last  beyond  the 
first  year,  although  older  children  sometimes 
are  affected.  The  treatment  consists  first  in 
rearranging  the  hygiene  of  the  baby's  life,  with 
particular  reference  to  the  diet.  The  food 
must  be  diluted  and  the  interval  of  feeding 
lengthened.  In  breast  fed  infants,  water 
should  be  given  immediately  after  each  feed- 
ing.    In    bottle    fed    infants,    skimmed    milk 


164  HEALTHYBABIES 

should  be  used  in  place  of  whole  milk  so  as  to 
reduce  the  amount  of  fats.  If  no  improve- 
ment is  shown  the  amount  of  sugar  also  should 
be  reduced.  The  child  should  be  given  plenty 
of  water  to  drink.  The  local  treatment  varies 
slightly  according  to  whether  the  eruption  is 
on  the  body  or  on  the  scalp. 

Local  Treatment  for  Eczema  of  the  Scalp 

The  affected  area  should  be  covered  with 
olive  oil  which  should  be  applied  freely  by 
means  of  muslin  cloths  dipped  in  it.  These 
should  cover  the  head  of  the  baby,  and  should 
be  kept  in  place  by  a  soft  cap.  They  should 
be  changed  twice  a  day,  when  the  oil  must  be 
renewed.  At  the  end  of  three  or  four  days,  the 
scalp  should  be  washed  with  warm  water  and 
soap,  and  effort  may  then  be  made  to  remove 
the  crusts  very  gently.  If  there  is  any  bleed- 
ing the  oil  applications  must  be  commenced 
again  as  no  force  must  ever  be  used  in  remov- 
ing the  crusts.  After  they  have  been  removed, 
a  soothing  ointment  should  be  applied.  This 
may  consist  of  a  mixture  of  equal  parts  of 
lime  water  and  sweet  almond  oil,  or  zinc  oxide 
ointment.  The  ointment  should  be  spread 
upon  muslin  and  kept  in  close  contact  with  the 
affected  area. 


MINOR    ILLNESSES    AND    AILMENTS        165 

Local  Treatment  for  Eczema  of  the  Body 

The  eruption  should  be  covered  with  some 
mild  ointment,  such  as  zinc  oxide.  No  water 
should  be  allowed  to  come  into  contact  with 
the  eczema  and  all  cleansing  must  be  done 
gently  by  means  of  soft  cloths  dipped  in  sweet 
oil. 

INTERTRIGO 

This  is  a  term  which  is  generally  applied  to 
an  intense  red  eruption  which  occurs  usually 
when  two  moist  surfaces  come  into  contact. 
Sometimes  it  is  thought  of  as  a  form  of  eczema. 
It  resembles  severe  chafing  and  sometimes  the 
skin  comes  off  over  fairly  large  areas,  and  the 
surface  is  moist.  There  rarely  is  any  formation 
of  crusts.  Intertrigo  usually  occurs  between 
the  thighs,  about  the  anus,  back  of  the  ears, 
in  the  axilla,  the  folds  of  the  neck,  or  in  other 
places  where  the  skin  folds  on  itself,  or  comes 
into  contact  with  any  other  part  of  the  body. 

Cause 

Usually  the  cause  is  dependent  upon  some 
form  of  uncleanliness,  that  is,  that  the  diapers 
are  not  changed  frequently  enough,  that  there 
has  been  excessive  perspiration  of  the  skin 
with  bathing  at  too  infrequent  intervals,  or  it 
may  be  that  the  bowel  discharges  have  been 
irritating. 


166  HEALTHYBABIES 

Treatment 

The  baby's  body  must  be  kept  scrupulously 
clean,  the  diapers  changed  as  soon  as  they 
have  been  soiled,  and  the  parts  of  the  body 
which  come  into  contact  with  any  other  part 
must  be  kept  dry  and  carefully  dusted  with  a 
good  talcum  or  boric  acid  powder.  When  in- 
tertrigo has  appeared,  the  area  should  be 
washed  carefully  and  covered  with  zinc  oxide 
ointment  or  stearate  of  zinc  powder.  The 
baby  should  be  given  plenty  of  water  to  drink 
between  meals,  the  milk  should  be  diluted, 
and  the  interval  of  feeding  lengthened.  In 
addition,  it  is  well  to  stop  the  use  of  sugar 
for  a  few  days  in  the  milk  formula. 

How  to  Prevent  Scratching  in  Skin  Diseases 

Eczema  and  other  itching  skin  diseases  are 
made  worse  by  scratching.  The  two  methods 
which  may  be  employed  to  prevent  the  child's 
irritating  himself  in  this  way,  are  by  the  use  of 
aluminum  mits  and  cardboard  cuffs  which  are 
placed  over  the  child's  elbows.  Both  of  these 
have  been  described  in  this  book  under  the 
heading  of  ''Treatment  for  Thumb-Sucking 
and  Nail  Biting." 

CROUP 

Croup  is  an  acute  spasm  of  the  larynx,  ac-; 
companied  by  a  harsh,  brassy  cough,  noisy  and 


MINOR    ILLNESSES    AND    AILMENTS        167 

difficult  breathing  and  occasionally  by  signs  of 
partial  suffocation.  It  is  not  common  in 
young  babies,  rarely  appearing  before  six 
months  of  age.  The  vast  majority  of  cases 
occur  when  the  child  is  from  three  to  six  years 
of  age.  There  seems  to  exist  in  some  children 
a  predisposition  to  croup,  which  may  be  a 
family  trait.  If  there  is  one  attack  there  are 
apt  to  be  others.  Sometimes  the  attacks  occur 
three  or  four  nights  in  succession.  Again,  there 
may  be  a  long  interval  between  them. 

Cause 

The  immediate  exciting  cause  of  croup 
seems  to  be  exposure  to  cold  or  some  form  of 
indigestion.  Large  adenoids  and  hypertro- 
phied  tonsils  often  are  predisposing  causes. 

Onset 

During  the  day  the  child  may  exhibit  some 
slight  difficulty  in  breathing  and  older  children 
may  have  a  hoarse,  rather  hollow  and  barking 
cough.  This  becomes  increasingly  worse 
towards  evening  although  the  child  may  finally 
go  to  sleep.  The  attack  itself  generally  comes 
on  about  midnight.  The  child  awakens  sud- 
denly, w4th  great  difficult}^  in  breathing,  loud, 
noisy  inspirations  with  a  characteristic  sound 
which,  once  heard,  is  rarely  forgotten.  The  child 


168  HEALTHYBABIES 

appears  to  be  in  great  distress.  The  mucous 
membrane  may  be  blue  and  sometimes  there 
seems  to  be  imminent  danger  of  suffocation. 
The  pulse  is  rapid,  occasionally  there  is  slight 
fever,  although  the  temperature  rarely  goes 
above  102.  Sometimes  the  child  is  quite  pros- 
trated, but  it  must  be  remembered  that  this 
disease  is  never  fatal  although  it  is  always 
alarming.  After  the  attack  subsides  the  child 
usually  falls  into  a  refreshing  sleep  and  seems 
quite  well  again  the  next  day.  There  may  be 
recurrent  attacks  of  croup  for  two  or  three 
nights  in  succession,  then  they  may  stop  for 
weeks  or  even  months. 

Prevention 

A  child  with  a  tendency  to  croup  should  be 
kept  in  the  open  air  as  much  as  possible.  If 
he  can  be  accustomed  to  cold  bathing,  so  much 
the  better.  In  any  event,  the  neck  and  chest 
should  be  sponged  with  cold  water  night  and 
morning.  If  adenoids  and  enlarged  tonsils 
are  present,  they  should  be  removed.  As  di- 
gestive disturbances  often  cause  croup,  care 
must  be  taken  to  see  that  anything  the  baby 
or  young  child  eats  is  readily  digestible.  In 
infants  too  rich  milk  or  too  frequent  feeding 
may  possibly  be  the  cause,  and  feeding  in- 
tervals should  be  lengthened  and   the  milt 


MINOR    ILLNESSES    AND     AILMENTS         169 


diluted.     For  older  children  tonic  treatment 
may  be  necessary. 

Treatment 

When  an  attack  occurs  the  best  remedy  is 
syrup  of  ipecac.  This  may  be  given  in  doses 
of  thirty  drops  every  fifteen  minutes  for  a  baby 
from  six  months  to  a  year  old  and  one-half  to 
one  teaspoonful  every  ten  to  fifteen  minutes 
for  a  child  of  two  years.  The  dose  should  be 
repeated  until  vomiting  occurs.  If  vomiting 
does  not  occur  after  two  or  three  doses  the 
child  should  be  given  a  teaspoonful  of  white 
vaseline  or  two  teaspoonfuls  of  goose  grease. 
Hot  flaxseed  poultices  or  hot  fomentations 
should  be  placed  around  the  child's  neck.  If 
there  is  much  difftculty  in  breathing,  a  croup 
kettle  should  be  used.  If  a  regular  croup 
kettle  is  not  available,  an  ordinary  tea-kettle 
can  be  made  to  answer  the  desired  purpose. 
It  should  be  two-thirds  full  of  water,  which 
must  be  boiling  vigorously  when  the  kettle  is 
taken  from  the  stove.  It  should  then  be 
placed  on  a  chair  close  to  the  bed  and  over  the 
bed  should  be  arranged  a  canopy.  This  may 
be  done  easily  by  raising  an  umbrella  and  then 
draping  sheets  over  it  so  that  the  child  is  under 
a  tent.  The  spout  of  the  kettle  is  then  inserted 
through  an  opening  in  the  sheet  and  the  child 
allowed  to  breathe  the  moist  and  steaming  air. 


170  HEALTHYBABIES 

Such  treatment  as  this  usually  loosens  up  the 
cough  and  vomiting  almost  invariably  relieves 
the  spasm.  If  the  attack  recurs  during  the 
night,  the  treatment  must  be  repeated.  The 
next  day  the  child  should  be  kept  quietly  in 
bed,  and  it  is  advisable  to  give  the  syrup  of 
ipecac  in  five-drop  doses  every  two  hours  dur- 
ing the  daytime  in  order  to  relax  the  spasm  of 
the  larynx. 

ACUTE  CATARRHAL  BRONCHITIS 

Acute  catarrhal  bronchitis  is  the  ordinary 
type  of  cold  which  is  common  in  infancy.  This 
particular  kind  of  cold  occurs  commonly  dur- 
ing the  first  year  and  diminishes  in  frequency 
during  the  second  year.  It  is  particularly 
common  in  undernourished  babies  or  those 
who  have  rickets.  Adenoids  and  enlarged  ton- 
sils also  seem  to  be  predisposing  causes. 

Cause 

The  immediate  cause  may  be  chilling  of  the 
body  surface  which  usually  comes  from  being 
overdressed,  and  then  having  the  body  sur- 
faces chilled  while  they  are  perspiring.  Cold 
air  alone  rarely  causes  colds.  Warm,  vitiated 
and  superheated  air  frequently  does.  Babies 
are  much  more  apt  to  take  cold  if  they  are  kept 
in  a  room  with  many  other  people,  and  are  not 
given  opportunities  for  being  in  the  fresh  air 


MINOR    ILLNESSES    AND     AILMENTS         171 

the  greater  part  of  the  twenty-four  hours. 
Colds  of  this  type  occur  as  secondary  com- 
plications after  measles  and  whooping  cough, 
or  some  other  infectious  disease. 

Symptoms 

There  usually  is  running  of  the  nose,  dif- 
ficulty in  breathing  owing  to  the  stoppage  of 
the  nasal  passages.  The  baby  is  apt  to  have 
a  distressing  cough  which  is  rather  harsh. 
Children  under  nine  months  of  age  rarely 
spit  up  any  mucus.  It  is  probable  that  the 
mucus  comes  up  into  the  throat,  and  then  is 
swallowed.  This  w^ill  sometimes  cause  vomit- 
ing which  may  consist  largely  of  mucus  with  a 
small  amount  of  food.  The  respirations  are 
apt  to  be  increased  in  frequency  and  accom- 
panied by  rattling  sounds  caused  by  the  mucus 
in  the  lungs.  There  sometimes  is  a  slight  in- 
crease in  temperature  up  to  100  or  102  degrees 
which  may  continue  for  two  or  three  days. 
The  baby  is  restless,  shows  loss  of  appetite,  and 
occasionally  there  is  fever  and  diarrhoea. 

Prevefition 

Babies  who  are  kept  in  the  open  air  most  of 
the  day,  and  who  sleep  in  well-ventilated 
rooms  seldom  are  affected  with  colds.  As  early 
as  possible  they  should  become  accustomed  to 
having  cool  sponge  baths  at  least  once  a  day, 


172  HEALTHYBABIES 

with  vigorous  rubbing  afterwards.  This  should 
be  given,  however,  only  when  the  skin  becomes 
a  good  pink  color  after  the  bath,  and  the 
mucous  membrane  of  the  mouth  and  under 
the  nails  is  a  deep  pink  or  red.  Digestive  dis- 
turbances must  be  avoided,  the  clothing  should 
be  light  in  weight  and  of  proper  warmth  for 
the  weather. 

Treatment 

Whenever  the  baby  has  a  cold  he  should  be 
kept  in  bed  during  the  attack.  It  is  absolutely 
essential  that  the  room  should  be  well-venti- 
lated, but  it  must  not  be  cold.  The  tempera- 
ture should  not  be  below  sixty-eight  degrees. 
Two  or  three  times  a  day  the  baby  should  be 
taken  out  of  the  room  while  the  latter  is  being 
aired.  A  dose  of  castor  oil  should  be  given  at 
the  onset  of  the  cold,  and  thereafter  the  child 
should  receive  plenty  of  water  to  drink.  If 
there  is  any  tendency  to  indigestion  the  feeding 
interval  should  be  lengthened.  Breast  fed 
babies  should  be  given  water  after  each  feed- 
ing and  bottle  fed  babies  should  have  the  milk 
diluted  for  a  day  or  two. 


CHAPTER  IX 

FOOD  RECIPES 

Albumen  Water 

The  white  of  one  fresh  egg  should  be  placed 
in  a  dish  and  separated  lightly  with  a  fork. 
Add  half  a  pint  of  water  and  a  pinch  of  salt. 
Shake  and  strain  through  fine  muslin.  Keep 
covered  in  a  cold  place. 

Rice  Water 

Two  heaping  tablespoonfuls  of  rice  should 
be  soaked  overnight.  In  the  morning,  add  a 
quart  of  water  and  a  pinch  of  salt.  Boil  for 
three  hours,  adding  water  from  time  to  time 
to  keep  the  quantity  at  one  quart.  Strain 
through  a  fine  cloth  and  keep  cold  until  used. 

Barley  Water 

One  tablespoonful  of  barley  grains,  one  pint 
of  water  and  a  pinch  of  salt.  Boil  for  three 
hours,  adding  w^ater  from  time  to  time  to  keep 
the  quantity  at  one  pint.  Strain  through  a 
fine  cloth  and  keep  cold  until  used.  If  pre- 
pared barley  flour  or  the  patent  barley  is  used, 
it  should  be  made  by  taking  a  level  tablespoon- 
ful of  the  flour  and  mixing  it  to  a  paste  with 
a  little  cold  water.  This  should  be  added  to  a 
pint  of  boiling  w^ater  and  the  whole  boiled  for 
thirty  minutes,  then  strained  and  cooled. 
During  the  process  of  boiling,  water  should  be 

173 


174  HEALTHYBABIES 

added  from  time  to  time  to  keep  the  quantity 
at  one  pint.  A  double  boiler  is  preferable  for 
preparing  the  barley  water  made  from  the 
flour.  If  an  ordinary  saucepan  is  used,  the 
mixture  must  be  stirred  constantly  to  avoid 
scorching. 

Oatmeal  Water 

One  tablespoonful  of  oatmeal  water  added 
to  one  pint  of  water  and  a  pinch  of  salt.  Boil 
for  three  hours,  adding  water  from  time  to 
time  to  keep  the  quantity  at  one  pint.  Strain 
through  a  cloth  and  keep  cool  until  used. 

Cereal  Gruels 

These  may  be  made  from  rice,  oatmeal  or 
barley.  If  the  grains  are  used  take  two  table- 
spoonfuls  and  soak  overnight.  In  the  morn- 
ing, cook  for  three  hours  in  a  double  boiler 
with  sufficient  water  so  that  the  product  is  of 
the  consistency  of  thin  gruel.  Strain  through 
a  coarse  strainer  and  serve  with  milk.  Gruel 
may  be  made  also  from  barley  flour  by  using 
four  level  tablespoonfuls  to  a  pint  of  water  and 
boiling  for  thirty  minutes. 

Whey 

Warm  one  pint  of  fresh  milk  to  blood  heat 
(tepid),  add  two  teaspoonfuls  of  Fairchild's. 
essence  of  pepsin  or  liquid  rennet.  Stir  quickly 


FOOD     RECIPES  175 

for  a  moment  only.  Let  the  mixture  stand 
until  it  is  chilled.  At  the  end  of  an  hour  break 
up  the  mixture  with  a  fork  and  strain  through 
fine  muslin.  The  liquid  is  whey  and  can  be 
used  for  infant  feeding  for  a  short  period  of 
time  in  cases  of  diarrhoea  or  vomiting. 

Junket 

This  is  made  in  the  same  way  as  whey  except 
that  it  should  not  be  broken  up.  The  jellied 
milk  can  be  used  for  feeding  children  over 
eight  or  nine  months  of  age.  One  or  two 
teaspoonfuls  of  cane  sugar  may  be  added  to 
the  above  recipe.  For  older  children  a  little 
vanilla  or  nutmeg  may  be  used  for  flavor. 

Beef  Juice — Hot  Method 

Take  half  a  pound  of  upper  round  or  sirloin 
steak.  Warm  slightly.  Sear  the  surface  by 
holding  the  meat  on  the  broiler,  close  to  the 
flame.  Cut  in  fairly  small  squares  and  press 
out  the  juices  in  a  meat  press,  lemon  squeezer 
or  potato  ricer.  Add  a  pinch  of  salt.  Place  the 
juice  in  a  covered  jar  and  keep  cold.  Before 
using,  it  may  be  warmed  slightly  by  placing  a 
small  portion  in  a  cup  which  is  set  into  a  pan 
or  larger  cup  containing  warm  water.  Beef 
juice  should  not  be  heated  until  it  is  more  than 
blood  warm. 


176  HEALTHYBABIES 

Beef  Juice — Cold  Method 

Chop  fine  one-half  pound  of  round  steak. 
Put  into  a  fruit  jar,  cover  the  meat  with  cold 
water  and  add  a  pinch  of  salt.  Place  the  cover 
on  the  jar,  and  put  the  whole  in  the  ice- 
box for  six  to  eight  hours,  shaking  occasion- 
ally. At  the  end  of  eight  hours  strain  the 
meat  and  liquid  through  a  fine  cloth.  This 
process  takes  longer  and  the  juice  is  not  quite 
so  palatable  for  older  children,  but  it  is  more 
economical,  and  the  resultant  beef  juice  is 
slightly  more  nutritious.  It  is  preferable, 
therefore,  to  prepare  the  beef  juice  for  young 
children  in  this  way.  It  may  be  heated  be- 
fore serving  by  placing  it  in  a  cup  which  is 
set  into  a  dish  of  warm  water. 

Scraped  Beef 

Scrape  a  slice  of  round  of  beef  with  a  dull 
knife  until  the  pulp  is  obtained,  but  none  of 
the  fiber.  This  pulp  should  be  made  into 
a  small  cake,  and  kept  cold  until  used.  Be- 
fore using,  a  small  portion  should  be  spread 
out  thinly  on  a  saucer,  a  pinch  of  salt 
sprinkled  over  the  top,  the  whole  placed  in 
the  oven  or  on  top  of  a  teakettle  for  a  min- 
ute or  two  until  heated  through  and  the  juice 
is  started. 


FOOD    RECIPES  177 

Coddled  Egg 

Put  an  egg,  without  removing  the  shell, 
into  a  saucepan  with  boiling  water.  Take  the 
pan  from  the  fire  at  once,  cover  and  leave  it 
for  seven  minutes.  The  egg  should  then  be 
taken  out,  and  only  the  white  used.  The  latter 
should  be  of  the  consistency  of  jelly. 

Chicken,  Lamb  and  Beef  Broth 

One  pound  of  meat  with  the  fat  removed 
carefully  should  be  cut  into  small  pieces. 
Cover  with  one  pint  of  cold  water  and  add  a 
pinch  of  salt.  Simmer  for  two  to  three  hours 
over  a  slow  fire,  adding  sufBcient  water  from 
time  to  time  to  keep  the  amount  at  least  one 
pint.  Strain,  let  cool  and  remove  the  top  layer 
of  fat.  The  broth  then  may  be  reheated,  and 
if  necessary,  diluted  with  a  small  amount  of 
water. 

Milk  Soup 

The  water  in  which  any  green  vegetables 
have  been  cooked  should  be  saved,  and  added 
to  hot  milk  in  the  proportion  of  one-half  of 
each.  If  necessary,  a  small  pinch  of  salt  may 
be  added  and  the  mixture  allowed  to  boil  for 
five  minutes. 

Vegetable  Soup 

Half  a  pound  of  lean  meat,  one  large  carrot 
cut  in  cubes,  two  potatoes  cut  in  cubes,J^soup 


178  HEALTHYBABIES 

greens  and  a  handful  of  spinach,  chopped  fine. 
One  quart  of  water.  Salt  to  taste.  Simmer  for 
three  hours,  until  all  vegetables  are  soft.  Mash 
and  put  through  a  coarse  strainer.  Other  veg- 
etables such  as  green  peas  or  celery  may  be 
added  or  substituted  in  season. 

Spinach  Soup 

The  spinach  should  first  be  cooked  well  and 
left  in  its  own  liquid.  Take  one  pint  of  milk, 
add  to  this  one  cupful  of  the  water  in  which 
the  spinach  was  cooked,  then  press  half  a  cup- 
ful of  spinach  through  a  fine  colander,  mixing 
this  with  the  milk.  Add  a  pinch  of  salt,  place 
the  whole  in  a  double  boiler,  and  cook  well  for 
fifteen  minutes.  The  soup  may  be  varied  a 
little  by  adding  a  tablespoonful  of  flour  which 
has  been  mixed  in  cold  milk  and  stirred  grad- 
ually into  the  soup.  This  thickening,  however, 
is  advised  only  for  older  children. 

Prune  Juice  and  Prune  Pulp 

Cook  prunes  until  they  are  very  soft,  adding 
enough  sugar  to  have  them  slightly  sweetened. 
The  juice  may  be  used  in  place  of  orange  juice 
for  young  babies,  while  the  cooked  prunes 
may  be  placed  in  a  fine  sieve,  and  the  pulp 
rubbed  through.  This  prune  pulp  may  be  fecji 
to  children  over  six  months  of  age. 


FOOD    RECIPES  179 

Bran  Biscuits 

Two  and  a  half  cups  of  bran,  one  and  a  half 
cups  of  white  flour,  one  cup  of  sour  milk,  one- 
half  teaspoonf ul  of  baking  soda,  one-eighth  cup 
of  butter,  two  tablespoonfuls  of  molasses. 
Bake  in  muffin  rings  with  strong  heat,  as  for 
bread.  If  desired,  the  muffins  may  be  split 
and  toasted  just  before  serving. 


CHAPTER  X 

NURSERY  REMEDIES 

Castor  Oil 
Dosage : 

Under  three  months,  1  teaspoonful. 
Three  to  six  months,  2  teaspoonfuls. 
Six  to  twelve  months,  1  tablespoonful. 

Calomel 
Dosage : 

Under  three  months,  one-tenth  grain  tab- 
let every  15  minutes  for  3  doses. 
Three  to  six  months,  one-tenth  grain  tab- 
let every  15  minutes  for  6  doses. 
Six  to  nine  months,  one-tenth  grain  tab- 
let every  15  minutes  for  9  doses. 
Nine  to  twelve  months,  one-tenth  grain 
tablet  every  15  minutes  for  10  doses. 
The  tablet  may  be  crushed  and  dissolved  in 
a  teaspoonful  of  water. 

Milk  of  Magnesia 

Phillips'  milk  of  magnesia  probably  is  the 
best  mild  laxative  to  use  for  children  under  one 
year  of  age.  It  should  be  given  in  teaspoonful 
doses  night  and  morning.  In  breast  fed  babies 
this  dose  may  be  given  immediately  after  the 
morning  and  night  nursings.  In  bottle  fed 
babies  the  dose  may  be  added  to  the  morn-' 
ing  and  evening  bottles  of  milk. 

180 


NURSERY    REMEDIES  181 

Rhubarb  and  Soda 

This  mixture  may  be  bought  already  pre- 
pared at  any  drug  store.  It  is  an  excellent 
mild  laxative  for  babies  and  children. 

Dosage 

Up  to  six  months  a  half  teaspoonful.  From 
one  to  three  years  one  teaspoonful.  The  dose 
should  be  given  twice  a  day,  after  feeding. 

Syrup  of  Ipecac 

This  is  the  best  medicine  we  have  for  croup. 
For  a  baby  under  six  months  of  age  it  should 
be  given  in  fifteen-drop  doses  every  ten  to 
fifteen  minutes  until  the  child  vomits.  From 
six  to  twelve  months  the  dose  may  be  increased 
from  a  half  to  one  teaspoonful,  repeated  at 
fifteen-minute  to  half-hour  intervals.  Not 
more  than  three  teaspoonfuls  should  be  given. 
Syrup  of  ipecac  may  be  used  also  if  the  child 
has  eaten  anything  that  is  indigestible,  and 
where  it  is  desirable  to  stimulate  vomiting  in 
order  to  empty  the  stomach  of  its  contents. 
Here  one  dose  usually  is  sufficient.  If  syrup 
of  ipecac  is  not  available,  vomiting  may  be  in- 
duced by  placing  one-quarter  teaspoonful  of 
mustard  or  a  teaspoonful  of  salt  in  a  glass  of 
lukewarm  water  and  forcing  the  child  to 
drink  it. 


182  HEALTHYBABIES 

Boric  Acid  Solution 

Add  one  tablespoonful  of  boric  acid  powder 
to  one  pint  of  water.  Boil  in  a  clean  dish  for 
five  minutes,  adding  water  from  time  to  time 
so  that  the  total  remains  about  one  pint. 
Pour  the  solution  into  an  absolutely  clean 
bottle  which  has  been  scoured  thoroughly  with 
hot  soapsuds  and  rinsed  with  boiling  water. 
Keep  the  bottle  corked  tightly. 

Flaxseed  Poultice 

For  severe  colds  or  croup  a  hot  flaxseed 
poultice  may  be  placed  on  the  child's  neck. 
It  should  not  be  allowed  to  remain  after  it  has 
cooled,  and  as  soon  as  it  is  removed  the  chest 
and  neck  should  be  rubbed  well  with  alcohol 
or  camphorated  oil,  and  then  covered  with  a 
piece  of  flannel.  To  make  flaxseed  poultices, 
take  a  pint  of  water  and  bring  it  to  a  brisk  boil. 
Powdered  flaxseed  then  should  be  sifted  grad- 
ually into  the  water  until  a  thick  pasty  mixture 
is  the  result.  A  large  square  of  gauze  or  old 
linen  is  laid  on  a  clean  table  and  the  flaxseed 
spread  on  this  to  a  thickness  of  about  an  inch, 
covering  an  area  large  enough  to  cover  the 
child's  chest  or  to  go  around  the  neck.  The 
edges  of  the  gauze  then  should  be  folded  over 
the  poultice,  making  three  or  four  layers  ia 
the  back  while  in  the  front  there  is  simply  the 


NURSERY    REMEDIES  183 

one  fold  of  old  linen  or  possibly  two  of  gauze. 
The  poultice  should  be  applied  as  hot  as  it 
can  be  borne  comfortably,  care  being  taken 
that  the  skin  is  not  burned. 

Carron  Oil 

This  probably  is  the  best  remedy  we  have 
for  serious  burns.  It  consists  of  equal  parts 
of  linseed  oil  and  lime  water.  The  mixture 
does  not  keep  well  and,  particularly  in  warm 
weather,  it  is  better  to  keep  the  ingredients 
separate  and  mix  them  as  needed.  It  must  be 
shaken  well  so  that  a  thick  emulsion  is  formed. 
This  should  be  spread  liberally  over  the  burn- 
ed surface,  and  covered  with  clean  gauze. 
Absorbent  cotton  is  then  placed  over  the 
surface  so  that  all  air  will  be  excluded. 

Stearate  of  Zinc 

A  greasy  powder,  to  be  used  freely  on  any 
chafed  surface  or  where  it  is  desired  to  use  a 
powder  that  will  keep  out  moisture.  It  is  ex- 
cellent in  cases  of  severe  chafing  or  prickly 
heat. 

Zinc  Oxide  Ointment 

This  is  a  good  remedy  for  burns,  scratches, 
chafing  or  various  forms  of  skin  diseases,  in- 
cluding eczema.  It  should  be  spread  thickly 
on  a  piece  of  sterile  gauze  or  old  linen,  and 


184  HEALTHYBABIES 

then  laid  over  the  affected  part.  The  dressing 
may  be  kept  in  place  by  fastening  the  gauze 
with  two  strips  of  adhesive  plaster,  projecting 
over  the  edge  of  the  gauze  and  adhering  to  the 
skin. 

Dusting  Powders  for  Delicate  Skins 

(a)  For  the  baby  with  slight  prickly  heat 
or  rash,  or  where  there  is  any  redness  of  the 
skin,  a  powder  made  of  one  part  boric  acid 
powder  to  four  parts  powdered  starch  is  ad- 
vised. 

(b)  If  the  skin  is  excoriated  or  the  chafing 
is  extreme,  a  powder  consisting  of  one  part 
zinc  oxide  to  five  parts  of  starch  will  be  found 
to  have  excellent  healing  properties. 

(c)  Talcum  powder:  Equal  parts  of  pure 
talcum  and  starch  form  an  excellent  dusting 
powder.  Plain  talcum  may  be  used.  It  is 
important  to  see  that  it  is  not  perfumed,  and 
that  it  is  of  the  finest  quality  obtainable. 


TABLE  OF  MEASURES 

Unless  otherwise  indicated,  a  tablespoonful 
and  a  teaspoonful  measure  should  be  level, 
not  heaping. 

Liquid  Measure 

4  teaspoonfuls  equal  one  tablespoonful. 

2  tablespoonfuls  equal  one  ounce. 

1  tumblerful  equals  eight  ounces  or  J^  pint. 

Dry  Measure 

4  teaspoonfuls  equal  one  tablespoonful. 
1  heaping  tablespoonful  of  cane  sugar  equals 
one  ounce. 

3  level  tablespoonfuls  milk  sugar  equals  one 

ounce. 
1  dram  equals  one  teaspoonful. 


185 


GLOSSARY 

Abdomen 

The  belly.     That  part  of  the  trunk  of  the  human  body 
between  the  chest  and  the  legs. 

Abdominal  Band 

A  broad  strip  of  flannel  or  other  material  placed  around 
the  body  over  the  abdomen. 

Abnormal 

Diflferent  from  the  normal  or  usual.     Contrary  to  the 
natural  condition. 


Abscess 


A  collection  of  matter  or  pus  in  any  part  of  the  body  as 
a  result  of  inflammation. 


Adenoids 


Aloes 


Anemia 


Bacteria 


A  mass  of  soft,  glandular  tissue,  situated  in  the  upper 
part  of  the  pharynx  or  throat,  just  back  of  the  posterior 
opening  of  the  nostrils.  When  enlarged  this  growth 
blocks  up  the  posterior  nasal  passage,  and  prevents 
breathing  through  the  nose.  All  children  have  some 
adenoid  tissue.  It  is  only  when  it  has  grown  to  such  an 
extent  that  it  interferes  with  nasal  breathing  or  pre- 
disposes to  constant  colds  or  ear  disease  that  its  removal 
by  surgical  means  is  desirable. 


A  bitter  drug.  Taken  internally  as  a  laxative.  Used 
externally  because  of  its  bitter  taste  and  because  it  is 
not  harmful,  except  when  taken  in  large  quantities. 

A  deficiency  in  the  haemoglobin  or  iron  which  normally 
is  found  in  the  corpuscles  or  cells  of  the  blood. 

Germs.  Bacteria  are  of  many  types,  each  usually 
associated  with  some  special  disease,  such  as  bacteria  of 
typhoid,  the  bacteria  of  diphtheria,  etc.  Many  bacteria 
are  entirely  harmless  and  need  be  noticed  only  when  they 
occur  in  larger  numbers  than  30,000|per  cubic  centimeter 
of  milk.  The  bacteria  which  cause  disease  usually  are* 
known  as  "toxic  bacteria." 


186 


GILOS  S  A  R  y 


Band 
Bassinet 

Bladder 


See  abdominal  band. 


A  basket,  box  or  similar  article,  lined,  and  prepared  for 
use  as  a  bed  for  a  newborn,  or  very  young  baby. 


The  organ  which  holds  the  urine  from  the  time  it  leaves 
the  kidneys  until  it  passes  from  the  body.  A  thin  sac 
in  the  front  part  of  the  pelvis,  just  in  front  of  the  uterus. 


Blood  Heat 


Tepid.     At   the   temperature   of   the   body   or  blood, 
normally  98.4  degrees  Fahrenheit. 


Body  Temperature 


The  normal  body  temperature  is  98.4  degrees  Fahren- 
heit. An  abnormal  body  temperature  is  anything 
higher  than  the  degree  mentioned. 


Brassiere 


A  breast  binder,  usually  fitted  in  so  that  it  adjusts  itself 
around  the  breast,  forming  a  natural  support,  without 
pressure.  Sometimes  it  is  made  simply  with  darts, 
sometimes  with  thin  flexible  bones  to  give  it  a  smooth 
and  even  shape. 

Breast  Binder 

A  band  placed  around  the  breast,  either  before  or  after 
confinement. 

Breast  Pump 

An  instrument  for  drawing  milk  out  of  the  breast. 

Buttocks 

(Breech.)  The  fleshy  part  of  the  body,  behind  the  hip 
joints,  forming  the  big  fleshy  mass  in  the  back  where 
the  upper  part  of  the  legs  join  the  body. 


Breech 


See  buttocks. 

187 


GLOS  S  A R  Y 


Cathartic 

A  medicine  which  acts  upon  the  bowels  in  a  manner  to 
produce  a  free  movement.  The  term  laxative  is  used  to 
denote  a  mild  cathartic.  A  cathartic  medicine  is  one 
which  produces  some  form  of  purging,  and  which  has  a 
stronger  effect  than  a  laxative. 


Chafing 


Catheter 

A  rubber  tube,  open  at  one  end,  and  with  one  or  more 
perforations  at  the  other  end.  It  is  used  by  introducing 
the  perforated  end  through  the  opening  in  the  bladder 
for  the  purpose  of  drawing  off  the  urine.  Should  never 
be  used  by  anyone  who  has  not  been  fully  instructed  in 
the  method  of  its  insertion. 

Irritation,  redness  and  inflammation  of  the  skin  caused 
by  friction  of  the  parts  or  between  the  folds  of  the  skin, 
etc. 

Circumcision 

Removal  of  all  or  part  of  the  prepuce  or  foreskin  of  the 
penis  or  genital  organ  of  a  male  child. 

Colon 

That  part  of  the  bowel  or  large  intestine  which  termi- 
nates in  the  rectum. 

Colon  Irrigation 

The  injection  of  water  or  other  fluid  through  the  rectum 
into  the  colon,  the  water  being  allowed  to  flow  in  and  out 
without  obstruction. 

Constipation 

The  state  of  the  bowels  where  no  movement  of  the  feces 
takes  place  for  a  definite  time. 

Constitutional  Symptoms 

General  symptoms,  such  as  fever,  increase  in  pulse  and 
respiration;  symptoms  of  general  illness.  Used  in  con- 
tradistinction to  local  symptoms  which  consists  of  signs 
of  injury  or  illness  in  any  one  part  of  the  body. 

Cutting  Ring 

A  ring  of  some  hard  substance,  such  as  ivory  or  celluloid 
used  by  the  baby  in  order  to  help  in  the  cutting  of  the  * 
teeth  through  the  gums. 

188 


GLO  SSA R Y 


Dentition 

The  process  of  cutting  teeth  or  the  eruption  of  teeth 
through  the  gums. 

Ear  Drum 

A  membrane  of  the  inner  ear  which  receives  sound 
impressions  and  from  which  the  impression  is  trans- 
mitted to  the  brain. 


Eczema 


Element 


(Milk  crust.)  A  skin  eruption  which  may  occur  on 
any  part  of  the  body,  but  which  is  more  common  in 
the  folds  of  the  skin.  When  it  occurs  on  the  scalp  it 
is  sometimes  known  as  "milk  crust." 


Any  one  of  the  primary  parts  of  a  thing.  The  different 
substances  from  which  anything  is  made  up  or  com- 
posed. 

Elimination 

A  throwing  off  or  setting  free. 

Enema 

A  rectal  injection,  usually  given  for  medicinal  purposes. 
Is  generally  of  plain  or  soapy  water,  and  acts  as  a 
mechanical  irritant  to  cause  the  bowel  to  move. 

Eructation 

The  act  of  belching  or  casting  off  wind  from  the  stomach. 

Faeces 

See  feces. 

Feces 

Matter  excreted  from  the  bowels. 
Fecal  Matter 

Same  as  feces. 

Fomentation 

A  stupe.  A  cloth  thoroughly  wet  with  water  or  some 
medicated  fluid.     Hot  fomentation.    Cold  fomentation. 

Fontanelle 

(Soft  spot.)     There  are  two  fontanelles — the  anterior 
and  the  posterior.     They  consist  of  soft  spots  in  the 
head  where  the  bones  have  not  entirely  united. 
Anterior  Fontanelle 

Situated  just  above  the  forehead.     Remains  open  for 
about  eighteen  months.     At  the  end  of  that  time  the 
bones  should  be  entirely  joined  together. 
Posterior  Fontanelle 

Situated  just  above  the  back  of  the  neck.  Remains 
open  about  six  weeks,  at  which  time  the  bones  should 
be  entirely  joined  together. 

189 


GLOSS AR Y 


Foreskin 

The  prepuce  or  fold  of  skin  which  extends  over  the 
glans  or  end  of  the  penis,  which  is  the  male  organ  of 
the  child. 

Formula — Formulae 

The  prescribed  method  of  preparing  a  combination  of 
substances.  In  baby  feeding  this  term  usually  refers 
to  the  mixture  of  the  various  ingredients  to  form  the 
proper  modification  of  milk  for  the  individual  infant. 


Gas 


Genital 


Term  used  to  denote  the  production  of  fermentation  in 
the  stomach  or  bowels. 


Pertaining  to  the  organs  of  generation  or  reproduction. 
Genital  Region 

That  part  of  the  body  which  contains  the  genital  organs, 
or  that  part  of  the  body  where  the  genital  organs  are 
situated. 

Germs 

See  bacteria. 
Hygiene 

Science  of  preservation  of  health  by  means  of  attention 

to  sanitary  surroundings  and  personal  habits. 
Incision 

A  cut. 
Infection 

The  communication  of  disease  germs  by  any  means. 
Infected 

Contaminated  with  infectious  matter,  as  "the  child  is 
infected  with  scarlet  fever." 
Infectious 

Contagious;  easily  communicated;  capable  of  extension 
by  infection. 
Inflammation 

A  diseased  state,  generally  localized  in  some  one  part 
of  the  body,  characterized  by  pain,  swelling  and  redness, 
with  or  without  fever. 

Ingredients 

The  elements  which  enter  into  the  composition  of  any 
mixture. 

190 


GLOSS AR Y 


Injection 

See  enema.  Water  or  watery  solution  thrown  into  any 
cavity  of  the  body,  as  a  rectal  injection,  for  the  purpose 
of  making  bowels  move.  Also  used  as  a  term  to  denote 
the  injection  of  fluid  underneath  the  skin  by  means  of 
a  hypodermic  syringe. 

Irrigation 

The  washing  out  of  a  cavity  by  a  stream  of  water  or 
other  fluid. 

Jaundice 

Yellowness  of  the  skin,  eyes  and  secretions  due  to  the 
presence  of  bile  pigment  in  the  blood. 

Laxative 

A  mild  cathartic.     See  cathartic. 

Malnourished 

Undernourished.  A  condition  of  the  body  characterized 
by  underweight,  poorly  developed  muscles,  pallor, 
anemia,  bodily  fatigue  and  lack  of  bodily  resistance  to 
disease.  Undernourishment  or  malnutrition  may  be 
caused  by  the  presence  of  physical  defects,  insanitary 
surroundings,  lack  of  proper  hygienic  living  conditions, 
over-excitement,  wrong  kind  of  food,  irregular  feeding 
or  underfeeding. 

Massage 

Rubbing  and  manipulation  of  the  body  to  strengthen 
the  muscles  or  other  tissues. 

Mastication 

The  act  of  chewing  food. 

Masturbation 

The  causing  of  sexual  excitement  by  friction  of  the 
genital  organs  by  rubbing  with  the  hand  or  the  clothing. 

Milk  Crust 

See  eczema. 

Modification  of  Milk 

A  term  used  to  describe  the  mixture  of  various  in- 
gredients, such  as  milk,  water  and  sugar  of  milk  to 
form  a  proper  preparation  for  infant  feeding. 

Modified  Milk 

See  modification. 

Mucus 

Liquid  secreted  by  the  mucous  membranes. 


191 


GLOSS  A R Y 


Mucous  Membrane 

Lining  of  cavities  which  communicate  with  the  external 
air,  as  the  nose,  mouth,  etc.  These  membranes  secrete 
a  fluid  called  mucus. 


Nausea 
Navel 

Nipple 


Sickness  at  the  stomach. 

A  pit  or  scar  in  the  center  of  the  abdomen,  left  by  the 
shrinking  of  the  umbilical  cord. 


The  small  protuberance  in  the  center  of  each  breast. 
Nipple  Shield 

A  contrivance  of  glass  with  rubber  nipple  in  the  center, 
the  whole  to  be  placed  over  the  mother's  nipple  to 
protect  it  when  it  is  sore. 

Nutrition 

The  proper  use  of  nourishment  to  build  up  the  body, 
and  make  it  healthy. 


Pacifier 


Penis 


A  term  used  to  describe  a  rubber  nipple  which  usually 
is  attached  to  a  base  of  celluloid,  and  used  by  children 
between  feedings  in  order  to  keep  them  quiet.  Its 
use  is  harmful,  because  of  the  possibility  of  infection, 
on  account  of  the  uncleanliness  of  the  pacifier  and 
because  the  constant  sucking  leads  to  the  formation 
of  misshapen  lips,  irregular  teeth,  protruding  upper 
jaw  and  adenoids  and  enlarged  tonsils. 


The  external  genital  organ  of  the  male. 
Percentage  Formula 

A  formula  for  infant  feeding  made  up  of  the  various 
ingredients,  such  as  milk,  water,  milk  sugar,  etc.,  in 
proportions  based  upon  the  percentage  of  fats,  car- 
bohydrates, proteids  and  mineral  substances  which  have 
been  determined  upon  as  the  proper  combination  for 
the  individual  child. 


Pores 
Pulse 


Minute  openings  in  the  skin.  Also  refers  to  the 
openings  of  the  sweat  glands. 

The  beating  of  the  heart  as  felt  through  the  wall  of  any' 
artery.  Usually  felt  best  in  the  front  of  the  wrist,  just 
at  the  base  of  the  thumb. 


192 


GLOSS  A R  Y 


Pus 

Matter  given  off  from  an  open  sore.  The  cream-like 
fluid  found  in  abscesses. 

Quassia 

A  bitter  drug,  having  slight  medicinal  value.  Generally 
used  because  of  its  bitter  taste.  It  is  used  in  infancy 
on  the  thumbs  and  forefingers  to  discourage  thumb- 
sucking  and  nail-biting.  When  diluted  it  is  used  as  an 
injection  for  worms. 

Rachitis 

See  rickets. 
Rectal 

Pertaining  to  the  rectum. 

Rectum 

The  lowest  part  of  the  bowel  from  which  the  feces  pass 
out  of  the  body. 

Respiration 

Breathing. 

Rickets 

A  disease  of  childhood  marked  by  tenderness  and 
softening  of  the  bones,  resulting  in  curvature  or  de- 
formity of  the  bones. 

Rupture 

A  hernia.  The  forcible  tearing  or  breaking  of  a  part. 
The  protrusion  of  a  loop  of  the  intestine  through  an 
opening  in  the  muscular  wall  of  the  abdomen. 

Saliva 

Spit.  A  clear  fluid  which  is  secreted  by  glands  inside 
of  the  mouth. 

Scurvy 

A  disease  due  mainly  to  the  use  of  improper  food. 

Secretion 

A  substance  separated  from  the  blood  and  given  off  by 

some  organ  of  the  body. 
Soft  Spot 

See  fontanelle. 

Spasm 

A  sudden,  violent,  involuntary  contraction  of  a  part 
or  the  whole  of  the  body,  due  to  muscular  action. 

Spasmodic 

Having  the  nature  of  a  spasm. 

193 


GLOSS  A R Y 


Suppository 

A  preparation  of  some  substance  which  melts  at  the 
temperature  of  the  body,  usually  introduced  into  the 
rectum  for  the  purpose  of  stimulating  the  bowels  to 
move. 

Sterile 

A  condition  showing  the  absence  of  harmful  germs. 

Sterilized 

Made  sterile. 
Stools 

Bowel  movements.     Feces. 

Temperature 

Degree  of  heat.  The  average  temperature  of  the  body 
in  health  is  98.4  degrees  Fahrenheit. 

Top  Milk 

The  cream  and  that  part  of  milk  containing  the  fats 
which  normally  rises  to  the  top  when  milk  is  left 
standing  for  any  length  of  time. 

Umbilicus 

See  navel.  A  pit  or  scar  in  the  center  of  the  abdomen 
left  by  the  shrinking  of  the  umbilical  cord. 

Undernourished 

See  malnourished. 

Urine 

Water  secretion  of  the  kidneys  which  flows  from  them 

into  the  bladder,  and  then  is  discharged  from  that  organ 

to  the  outside  of  the  body. 
Ventilation 

The  supply  of  fresh  air  to  any  enclosed  space,  as  a  room. 


Vitiate 


Wind 


To  lower  the  bodily  vitality.  To  lower  the  standard 
of  any  substance,  such  as  vitiated  atmosphere,  where 
there  is  not  sufficient  oxygen.  The  air  in  a^  room 
becomes  vitiated  through  lack  of  proper  ventilation. 

See  gas. 


194 


NOTES 


195 


NOTES 


196 


NOTES 


197 


NOTES 


198 


NOTES 


199 


NOTES 


200 


NOTES 


201 


NOTES 


202 


NOTES 


203 


BABY'S  RECORD 


Name 

Place  of  birth 

Date  of  birth _ 

Hour  of  birth 

Attending  physician 

Attending  nurse 

Birth  registered 

Father's  name.._._ 

Mother's  name 

Christened  on 

At 

By  the  Reverend 

Persons  present 


204 


BABY'S  WEIGHT 

At  birth lbs oz. 

At  one  week lbs — oz. 

At  two  weeks lbs oz. 

At  one  month lbs oz. 

At  two  months lbs oz. 

At  three  months..^ lbs. oz. 

At  four  months.-- lbs oz. 

At  five  months lbs — oz. 

At  six  months lbs oz. 

At  seven  months lbs — oz. 

At  eight  months lbs oz. 

At  nine  months lbs oz. 

At  ten  months lbs oz. 

At  eleven  months lbs oz. 

At  twelve  months lbs oz. 

BABY'S  HEIGHT 

At  birth.-.- inches 

At  three  months inches 

At  six  months inches 

At  nine  months inches 

At  twelve  months inches 

BABY'S  FIRST  BIRTHDAY 

Baby  is  one  year  old  today 

and  is. inches  tall,  and  weighs .....pounds. 

205 


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206 


BABY'S  DEVELOPMENT 

First  outing. _ 

First  noticed  father  or  mother 

First  held  head  erect 

First  sat  up  alone .^ 

Began  to  creep  on 

Stood  alone 

Took  first  step 

Began  to  walk. 

First  smile 

First  laugh _.. 

First  tooth  appeared 

Spoke  first  word 

Baby's  sayings 

207 


RECORD  OF  FEEDING 


Date 

Formula 

Feeding 
Interval 

No.  of  Feedings 
Per  Day 

208 


SPECIAL  EVENTS 
Illnesses: 


Medications : 


Change  of  Routine 


209 


DESIGNED  ENGRAVED 

PRINTED 

BUREAU  OF  ENGRAVING.  iNC 

MINNEAFOLIS. 
MINN. 


"^Itmi'rf  "NIVERSITV  LIBRARfES 


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DATE  DUE 


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